April 3, 2009 By Blake Harris
Photo: Shaun Grannis, M.D., Regenstrief Institute research scientist and Indiana University School of Medicine assistant professor of family medicine.
In recent years, the potential challenges of a serious pandemic has been a key focus of discussions at disaster management conferences I've attended. Timely response is a critical factor. This includes not only communication with the general public, but also rapid alerts from public health departments to doctors and hospitals.
And even for more routine health concerns, there is still the task of notifying thousands of health care providers about disease outbreaks or illness from food borne contaminants.
Researchers from the Regenstrief Institute, Inc. in collaboration with the Marion County Health Department (Indianapolis, Ind), have developed and tested a technology that allows public health officials to abandon a traditional, inefficient paper approach to alerting the medical community about public health crises in favor of an electronic strategy to seamlessly and instantly push out information critical to patient care.
To enable instant delivery of public health alerts to physicians, Regenstrief health-care information technology professionals have created a web application that interfaces with their DOCS4DOCS service, operated by the Indiana Health Information Exchange (IHIE).
DOCS4DOCS is a clinical messaging service that delivers more than one million messages, such as laboratory or other test results, to physicians and other care providers each day throughout central Indiana. Using the new system, Marion County Health Department will now be able to rapidly send alerts to doctors.
Like most other public health departments across the nation, the Marion County Health Department has traditionally performed the public health alert function using a variety of methods, including news releases targeted to the public and posting letters to physicians. However, depending upon the postal service can delay physician notification by days - too long in many types of emergencies.
"One of the best ways to stop disease outbreaks is to rapidly identify and treat the cases," explained Joseph Gibson, MPH, Ph.D., director of epidemiology, Marion County Health Department.
"So when a public health department detects an outbreak, it is often important to rapidly notify all the doctors in the area, so they may increase their index of suspicion for the illness, and do more testing and treatment."
"Maintaining accurate contact information for doctors in a city the size of Indianapolis can be challenging. That's where the well-established DOCS4DOCS alert system will be advantageous. DOCS4DOCS maintains the system, so the health department is relieved of the effort of trying to keep their contact information up to date," said Gibson.
Through Regenstrief Medical Records System, the Regenstrief Institute has been capturing and aggregating health-care data from throughout Central Indiana since 1994. As a result, metropolitan Indianapolis is the most health-care wired city in the nation.
"Our public health broadcast messaging initiative leverages Regenstrief's core standards-based health information exchange infrastructure in novel ways to improve the health of our community. By building on existing proven technology already used for clinical health care, we minimize development costs and rapidly implement technology that delivers real-world value to public health," said Shaun Grannis, M.D., Regenstrief Institute research scientist and Indiana University School of Medicine assistant professor of family medicine.
Last year Regenstrief investigators received a $10 million, 5-year contract from the Centers for Disease Control and Prevention (CDC) to accelerate the real-time ability of local, state and regional entities to share data and information to enhance rapid response to and management of potentially catastrophic infectious disease outbreaks and other public health emergencies.
"DOCS4DOCS is a robust, efficient communication system that can reach virtually all health-care providers in the Indianapolis metropolitan area. It is a prime example of a bidirectional communication system that other communities should seriously consider for implementation," said Charles Magruder, M.D., M.P.H., senior advisor, Health Information Exchange Activities, National Center for Public Health Informatics at the CDC.
After further evaluation, Regenstrief plans to offer the new technology to other public health departments.
This Digital Communities white paper highlights discussions with IT officials in four counties that have adopted shared services models. Our aim was to learn about the obstacles these governments have faced when it comes to shared services and what it takes to overcome those roadblocks. We also spoke with several members of the IT industry who have thought long and hard about these issues. The paper offers some best practices for shared government-to-government services, but also points out challenges that government and industry still must overcome before this model gains widespread adoption.