One hundred and sixty-six years after Samuel Morse used dots and dashes to telegraph "What hath God wrought?" opening up a whole new world of communication, Indiana has become the first state in the nation to use a potentially equally revolutionary tool, the Nationwide Health Information Network, to convey public health information to the U.S. Centers for Disease Control and Prevention (CDC).
In the historic 2010 transmission, de-identified information on new cases of influenza, pneumonia, and influenza-like illness was gathered from 76 emergency departments across the state and sent to CDC by the Regenstrief Institute on behalf of the Indiana State Department of Health (ISDH).
The Nationwide Health Information Network facilitates sharing of data simultaneously with the Indiana State Department of Health and, with state concurrence, CDC. This type of data sharing can result in more timely identification and characterization of emerging public health events that cross state boundaries and may lead to improved multi-state and federal situation awareness.
"Leading health informatics applications like the Nationwide Health Information Network can have significant positive impact on public health in Indiana by revolutionizing the way the State Department of Health and our partners, such as CDC and Regenstrief, share and report data," said State Health Commissioner Gregory N. Larkin, M.D. "Timely and efficient reporting of data is essential to the Indiana State Department of Health's disease surveillance and investigation."
The Nationwide Health Information Network enables secure health information exchange over the Internet and provides a foundation for the exchange of health information within communities and across the country. In addition to enabling health information to follow an individual and to be available for clinical decisions, it had been envisioned that the Nationwide Health Information Network would take, with appropriate safeguards, health care information beyond direct patient care to improve population health. CDC has been a critical partner at the table with other federal agencies to ensure that the Nationwide Health Information Network can be used to support ongoing efforts at state and national levels to improve surveillance of disease.
"Regenstrief has been a major contributor to the design and development of a national health information superhighway. Working with the CDC and the Indiana State Department of Health, we are now the first to deploy a specific type of vehicle that can travel on the highway. Public health data exchange over the Nationwide Health Information Network will improve disease detection and biosurvellience while safeguarding patients' personal information. It also enhances public health agencies' ability to electronically capture and exchange health care information with providers without new regulations or policies. I think this is a win-win for everyone," said Brian E. Dixon, M.P.A., a Regenstrief Institute program manager.
The Regenstrief Institute is the home of the Indiana Center of Excellence in Public Health Informatics, one of only four such centers in the nation. The Center, established with CDC funding, builds upon the unique capabilities of the Indiana Network for Patient Care to securely exchange health information when and where needed for purposes of medical treatment. INPC, developed by Regenstrief physician-researchers, currently allows medical providers across the state to securely obtain patients' medical histories, providing information critical to patient care. Nowhere else in the nation can this be done. The institute is the World Health Organization's first and only Collaborating Center for Medical Informatics.
"With input from CDC and the Indiana State Department of Health plus our extensive work in informatics and biosurveillance, we are leveraging Regenstrief's strengths in truly novel ways to improve the health of our state and eventually the nation. By building on existing proven technology already used for clinical health care, we are minimizing development costs and rapidly implement technology that delivers real-world value to public health," said Shaun Grannis, M.D., the Regenstrief Institute investigator and IU School of Medicine assistant professor of family medicine, who directs the Indiana Center of Excellence in Public Health Informatics.
CDC, along with other federal partners, supports the emerging Nationwide Health Information Network for enabling greater access to healthcare and public health information. CDC went into limited production with CONNECT in Spring, 2010.
Use of the nationwide network to report public health information builds on a number of recent federal and private sector partnerships that have developed a secure, information superhighway that exchanges health care information. The Social Security Administration is using the Nationwide Health Information Network to exchange medical records to improve the disability determination process and the Department of Veterans Affairs is using it to exchange medical records to improve coordination of care between a veteran's health care providers.