Harmonizing Content of Public Health Surveillance Systems: Lessons Learned from the ONC Standards and Interoperability (S&I) Public Health Reporting Initiative (PHRI)

BACKGROUND:  

There is increasing demand to standardize public health surveillance systems and develop actionable health information. In 2012, partners from the ONC S&I PHRI collaborated to complete the Data Harmonization Profile (1). This document represents common core data elements for public health reporting.

METHODS:  

PHRI partners identified and defined common core data elements as those elements that are widely used across public health reporting programs and solicited user stories and reporting scenarios across the public health community.  These stories were analyzed and discussed in small working groups organized around the following public health domains: adverse events; child health; chronic disease; communicable disease; and infrastructure, quality and research. Data elements specific to each domain were reviewed and evaluated for commonality and re-usability across user stories to establish the common core data elements for public health reporting. 

RESULTS:  

The Data Harmonization Profile describes how various public health domains currently use the common core data elements.  The common core data elements are aligned with recommendations from the International Society for Disease Surveillance (ISDS) and the Council of State and Territorial Epidemiologists (CSTE) and also with Healthcare Information Technology Standards Panel (HITSP), Federal Health Information Model (FHIM), and Clinical Document Architecture (CDA) standards.  Partners also identified algorithms for data harmonization, lessons learned, and next steps for different categories of users (e.g., system developers, implementers, data analysts). Proposed future activities include determining maintenance mechanisms for the harmonized set of common core data elements, defining implementation guidance and testing of them in pilots, and broadening the scope of the public health reporting scenarios.

CONCLUSIONS:  Data element harmonization efforts undertaken by ONC S&I PHRI underscore the importance of further dialog between partners in various public health domains to carefully evaluate business processes; expected standards, specifications and other technical documentation; and data content already existing in electronic health IT systems. The use of common core data elements will increase the standardization of public health surveillance systems and contribute to the development of a strategic roadmap for harmonized data collection and  interoperable public health surveillance systems.