Connected Health Networks Create an Opportunity

In the last decade, public health has made significant investments in disease surveillance, reporting, and management systems. They have made a significant investment in their immunization systems and in the electronic connections to providers that have increased the quality and quantity of data that is available.

One result which can be highlighted today is these investments have significantly improved public health preparedness during this present outbreak. The ability to report COVID-19 test results electronically to public health and CDC, rapidly create new patient and contract tracing forms and better manage this information is saving time supporting the impact on limited resources of health professionals.

Today immunization registries are capable of managing patient immunization events, tracking vaccine delivery, monitoring utilization of inventories to the dose level and providing real-time decision support to a clinician or pharmacist while their patient is receiving a requested or recommended immunization.

In 2020, our joint public health infrastructure is 50 times more efficient than in 2009 when the H1N1 pandemic occurred, and 100 times more effective after Anthrax in 2001. These technology resources are an asset to all working with the current pandemic. Every state has made progress. There are gaps that are highlighted when under stress. But these gaps are relatively minor when compared to the information systems in 2009 or 2001. Most importantly these gaps can be closed relatively quickly because of what exists today.

We at STC have worked across this technology ecosystem for 31 years. We see the next key is to connect more health care professionals and consumers to these existing public health networks. As connectivity grows we can increase value by building on immunizations adding RDT reporting and analytics that utilize the growing data assets. 

Four suggested “next steps” to increase the public health infrastructure are summarized below.

1. Strengthen the current data exchange network. Congruently, we propose to expand the 31,000+ pharmacy, 3000 EHR, and 1000 school locations currently connected to public health immunization systems to 50,000 total. The current number of connections varies by state with rural locations less served. Expanding this network to 50,000+ bi-directional connections increases the capacity of immunization programs everywhere.  Without these connections, state immunization systems have missing data that would prove valuable in supporting current vaccine programs as well as when a new vaccine is released. 

An emphasis will be placed on the retail pharmacy. The pharmacist is in a unique position to help. Approximately 90% of all US citizens live within 5 miles of a retail pharmacy location. With this type of reach and the ability for all occasions to share data with public health, we support closing the care gaps for all individuals within your state.

Our goal is to connect locations, public and private health care providers who provide vaccinations, ensure data is electronically reported to public health and real-time access through to data is available to the provider.                                 

1. Engage the consumer. We propose to expand consumer access to state immunization systems. This will be accomplished directly through partnerships with public health and through this network leveraging the pharmacy customer relationships. Partnering with pharmacies has demonstrated significant value when individuals have access to their family immunization histories. Increased awareness and uptake of other recommended vaccinations continue to help individuals avoid vaccine-preventable diseases. 

Our goal is to empower individuals through improved access to their immunization histories. 

1. Pharmacy remote diagnostic testing reporting and home COVID-19 diagnostic test reporting. We propose to add to this connected infrastructure the ability to report COVID-19 test results to public health from home or if in the future Pharmacy testing. In addition, as the clinical roles of pharmacists increase,  these networks will expand to report rapid diagnostic testing to public health. Part of supporting this infrastructure is ensuring pharmacists are allowed to test and initiate treatment for flu, strep, and minor ailments to alleviate stress on the rest of the medical community to help with treating COVID-19.  

Our goal is to deliver through this connected network pharmacy RDT results to public health and include a consumer reporting component.  

1. Analytics for Use. Currently, this existing network supports the immunization records of over 70 million individuals. The 31,000 pharmacies alone have reported over 600 million immunization events to public health in the last few years and nearly every day 1 million immunization forecasts are provided to a practitioner or pharmacist at the point of care. Data and reporting capabilities will continue to be an urgent need as public health fights to contain this disease and continue their efforts with all VPD. 

Our goal is to implement public health dashboards that deliver analytics to end-users supporting the objective of what gets measured improves. Furthermore, this analytical effort will expand information by populations and geographically to advance public health immunization program goals and provide views of immunization coverage to state health leaders and the CDC.