JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic revealed major gaps in public health agencies’ (PHAs) data and reporting infrastructure which limited public health officials’ ability to conduct disease surveillance, particularly among racial/ethnic minorities disproportionally affected by the pandemic. Leveraging existing Health Information Exchange Organizations (HIOs) is one possible mechanism to close these technical gaps as HIOs facilitate health information sharing across organizational boundaries.

Objective:

To assess current HIO connectivity with PHAs and HIOs’ capabilities to support public health data exchange.

Methods:

We conducted a nationwide survey of all HIOs in 2023 to capture current and potential support for PHAs. We report descriptive statistics on services and data available to support PHAs, funding sources, and barriers to public health reporting.

Results:

Of the 135 HIOs that received the survey, 90 were determined to be eligible, and 77 completed the survey, yielding an 86% response rate. Of the 66 (86%) of HIOs in 45 states electronically connected to PHAs. Among HIOs connected to PHAs, the most common public health reporting supported by HIOs was immunization registry (64% of HIOs), electronic laboratory result (63%), and syndromic surveillance (61%). 58% of HIOs connected to PHAs provided data to address COVID-19 information gaps, and 64% provided at least one type of data analytic service to PHAs to support COVID-19 pandemic response. Top HIO reported barriers to support PHA activities included limited PHA funding (32% of HIOs) and PHAs’ competing priorities (23%).

Conclusions:

Our results show that many HIOs are already connected to PHAs and that they are assuming an emerging role to facilitate public health reporting. HIOs are well-positioned to provide value-added support for public health data exchange and address PHA’s information gaps as ongoing federal efforts to modernize public health data infrastructure and interoperability continue.