Public health left out of regional exchanges?

The movement to set up data exchanges among health care institutions hasn’t included public health organizations, officials said at last month’s Connecting Communities for Better Health meeting in Washington, D.C.

“Public health is not engaged right now,” said Dr. Farzad Mostashari, an assistant commissioner at the New York City Health and Mental Hygiene Department.

He said government health agencies should be involved in regional health care information exchanges (RHIOs) because such systems need to make connections between individual health problems and potential epidemics. Many public health departments focus on the latter.

For example, during a flu epidemic, physicians need to know about the virus and its symptoms, and public health officials need to collect data, Mostashari said.

Speaking during the same public health conference, Dr. Perry Smith, New York’s chief epidemiologist, decried “the mood in this room of being a second-class citizen.” He said a lack of funding for new programs and technology hampers public health participation.

Mary Shaffran, a principal director of finance at the Association of State and Territorial Health Officials, titled one slide of a presentation “Public Health as an Afterthought.” But she said some emerging RHIOs include participation by state and local public health departments.

In Utah and Rhode Island, for example, state government agencies with federal funding are leading statewide public/private initiatives, Shaffran said.

Meeting participants said public health agencies are mostly funded to perform specific functions, such as epidemiology and sanitation, and are limited to those functions.

On the other hand, public health officials have not always seized the opportunity to participate, they agreed. “I think public health has a huge challenge with leadership,” said David Ross, director of the Public Health Informatics Institute.

Public health departments have received funding for surveillance systems that monitor indicators of population health to detect biological or chemical attacks. For maximum effectiveness, surveillance systems should exchange data with RHIOs, officials said at the meeting.


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