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BACKGROUND: Height and weight data (HWD) have long been part of medical “vital signs”, useful for making recommendations and decisions about an individual’s health care. With the advent of electronic health records (EHRs), HWD are increasingly available electronically. One aspect of Meaningful Use defines standards-based information exchanges of clinical data, enabling electronic data from disparate EHRs to help public health practitioners make decisions about the population’s health care.
METHODS: The Healthy Weight Surveillance Project (HWSP) at the US Centers for Disease Control and Prevention (CDC) sponsored a demonstration of standards based population health monitoring at the Integrating the Health Care Enterprise (IHE, http://ihe.net) initiative. IHE uses existing standards to develop “profiles”, which detail how and when standards are used to implement specific information exchanges. Annually, EMR vendors develop capabilities in their software to implement those profiles, certify through a technical session called the “Connectathon” and then demonstrate the profiles publically at a “Showcase” event involving over 115 vendors, at the Health Information Management System Society (HIMSS) annual meeting. In 2013, a draft IHE Healthy Weight profile was released, and during the winter of 2014, the use of that profile in local and state health departments will be tested and demonstrated at the Connectathon and HIMSS Showcase, with San Diego County and Washington State/University of Washington showing how public health agencies value and interact with these population health data.
RESULTS: The IHE Healthy Weight profile supports two standards based methods to use the HWD routinely recorded in EHRs during clinical visits. The first method uses an HL7 message standard similar to that used in immunization registries. The second method uses a “CDA” clinical document, essentially a structured, electronic clinical visit summary, and a clinical repository architecture similar to the models used by some health information exchanges. Both the specialized registry and the more general clinical repository support population based HWD surveillance. The specific standards, architectures and demonstration systems certified at the Connectathon and shown at HIMSS will be used to illustrate the processes
CONCLUSIONS: The CDC HWSP establishes the basis for ongoing population health monitoring of HWD. IHE’s new Healthy Weight profile supports the technical architectures needed for such monitoring, does so using standards identified through Meaningful Use, and provides public health agencies with the data needed to make and monitor good decisions. The IHE demonstration of HWSP allows both IT and public health stakeholders to see the feasibility and assess the utility of such surveillance.