Public health agencies aren’t making it easy for providers to attest to the public health objectives folded into the meaningful use program. But federal agencies have set up new policies as well as new formatting and testing tools to ease the pain of working with “beleaguered” public health agencies, says Seth Foldy, M.D., director of Public Health Informatics and Technology Program Office at the Centers for Disease Control and Prevention.

Three meaningful use objectives are focused on public health reporting: reporting to immunization registries, electronic lab reporting of reportable conditions, and syndromic surveillance.

Because of the difficulties public health agencies have had testing connections and onboarding a deluge of hospitals and eligible professionals, ONC made a significant change to ease the pressure: Hospitals and EPs that are in the testing queue with a state agency to exchange public health data can attest they have met that requirement, until such time they’re required to submit production data.

The reason for the change is that public health simply can’t keep up, Foldy told a packed room at the HIE symposium Monday, Feb. 20 at the HIMSS12 conference in Las Vegas. The agencies must replace their legacy systems to use national standards, as do most of their providers, while at the same time public health has been hit hard by state belt-tightening. More than 50,000 public health workers have been pink-slipped, along getting their budgets chopped, and information exchange initiatives such as the CDC’s BioSense project also faced funding shortfalls.

“When it comes to health information exchange, this has been the year of living dangerously for public health,” Foldy says. “Onboarding providers to exchange public health data has typically been done in a pretty leisurely fashion, but meaningful use changed all that. Agencies are really having problems scaling up right now—information exchange is a long-term positive that has created a lot fo short-term disruption.”

Resources to track the progress of standards development, and public health data exchange formatting and testing, are available at:;; and




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