Innovating Public Health Response to Healthcare-Associated Infection Outbreaks By Understanding Barriers and Benefits to Electronic Health Record Access

Brief Summary:
Efficient exchange of electronic health records (EHRs) strengthens the role of state health agencies in healthcare-associated infection (HAI) prevention as well as outbreak investigation, and has great potential to aid numerous other public health purposes.  Currently, access and exchange of electronic health data are nascent and uneven in adoption.  Policy gaps prevent timely state health department access to EHRs, hindering health agency efforts to monitor cases and stop disease spread.  ASTHO and CDC are collaborating on several initiatives to assess policies, practices, and legal barriers that affect state health agency remote access to EHRs, including: 1) a capacity building project with the Virginia Department of Health focusing on benefits and policy/technologic barriers for remote access to hospital electronic medical records (EMRs); and 2) a multi-state assessment of the impact of EHR access on state outbreak response during the 2012-2013 fungal infections outbreak and other healthcare-associated outbreaks. In Virginia, after conducting a review of the existing literature on public health’s ability to access hospital electronic medical records, the project team used a mixed methods approach to collect qualitative and quantitative data from Virginia health department staff (from district health departments and Central Office), Virginia hospital infection preventionists (IPs), Virginia hospital privacy officers/directors of information management, and staff from other state health departments. When hospitals share remote EHR access with public health departments, both organizations benefit.  Local and state-level health department staff from Virginia and other states noted improvements to data quality and timeliness of disease and outbreak investigations, as well as savings in time and travel costs.  Hospital staff, especially IPs or those who work in the medical records department also reported saving time and effort associated with obtaining and transmitting information to public health. During this roundtable, presenters from the Virginia Department of Health, ASTHO, and CDC will share information gathered from the Virginia and multi-state assessments.  Participants will have the opportunity to discuss experiences and lessons learned around remote EHR access in their jurisdictions, and consider efforts that may advance program and policy efforts in this field.