Leveraging Electronic Health Records Access for Improving Healthcare-Associated Infection Outbreak Investigation

Key Objectives:
During this roundtable, presenters will provide an overview of results from a qualitative assessment of policy gaps and strategies for supporting electronic health record (EHR) exchange for the purpose of healthcare-associated infection (HAI) outbreak response.  Presenters will share a toolkit based on interviews with state health agency staff, and preliminary findings from healthcare facility interviews. Participants will be invited to share experiences and lessons learned around remote EHR access in their jurisdictions, and brainstorm policies, tools, and activities that would position their health agencies for improving and accelerating exchange of EHRs for outbreak investigations.

Brief Summary:
State health agencies rely on the efficient exchange EHRs when investigating and responding to HAI outbreaks.  However, access and exchange of electronic health data are nascent and uneven in adoption across the country, and policy gaps often prevent timely state health agency access to EHRs. The 2012-2013 fungal meningitis outbreak highlighted the need to better understand the landscape of granting and utilizing EHR access for the purpose of outbreak investigations.  In an effort to identify policy gaps and strategies for supporting efficient EHR exchange, the Association of State and Territorial Health Officials (ASTHO) and the Centers for Disease Control and Prevention (CDC) partnered on a retrospective evaluation of challenges surrounding health agency access to EHRs during HAI outbreak investigations.  Interviews were conducted with staff from twelve state health agencies involved in the fungal meningitis outbreak response and/or other HAI outbreaks of significance.  A diverse array of staff positions were interviewed, including the HAI coordinator, state epidemiologist, informatics director, and legal counsel.  A subsequent series of interviews solicited perspectives from healthcare facility staff in the twelve states, including infection preventionists, informatics directors, and clinic directors.  Together, the two-part assessment characterizes challenges and opportunities for reliable and timely EHR access, from both sides of the data exchange process.  Tools and strategies collected from the interviews will be disseminated to support state health agencies in their efforts to improve EHR exchange.