TOOLS FOR HEALTH DEPARTMENTS
Best Practices for Access and Use of Electronic Health Records
Public health departments depend on timely, reliable, and accurate information to carry out their roles in disease surveillance and outbreak investigations.
During prior outbreak scenarios, such as the 2012-2013 fungal meningitis outbreak, health department staff traveled to each of the affected healthcare facilities to review patient health information through paper copies, PDF documents, or access to their electronic health records (EHR).
With new technologies, you can use remote access to EHRs to improve the efficiency of the outbreak responses. Because staff no longer have to travel to multiple healthcare facilities to review patient health information, the health department saves time and resources. Remote access to EHRs can also improve the efficiency of outbreak investigations for healthcare facilities staff because staff no longer have to copy, fax, or email patient health information.
“If we could have more remote access, that would be ideal. There are a lot of resources that go into onsite visits to a facility to do the chart review.”
– Health Department Staff
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Currently, electronic health information is not standardized among healthcare facilities, and this lack of standardization makes interoperability challenging. EHR access differs between facilities (sometimes, even within the same facility) depending on the type of EHR system or software used and how the healthcare facility has set up the system. Additionally, types of patient information the system captures and the ability to search for specific information within the EHRs can vary significantly across healthcare facilities. There could be significant obstacles at health departments or healthcare facilities related to the access and use of EHRs, such as:
● Lack of resources to implement, upgrade, and maintain an EHR system;
● Lack of resources to train and retain health information technology (Health IT) staff, public health officials, and other staff who will access the system;
● Lack of standardization among the systems used by healthcare facilities; or,
● Some rural or small facilities may face IT challenges due to lack of infrastructure or their remote location.
“There is the travel, expense, and time out of the office. [Onsite EHR access] is not the most efficient way to do things.”
– Health Department Staff
Best Practices for Health Departments
- Involve people with the needed skills and in the right roles from the beginning, including but not limited to the board of directors, administration teams, clinical leaders, and facility and department directors.
- Build relationships with EHR vendors.
- Educate and train those responsible for accessing and using EHRs.
- Explain the benefits of granting access.
- Explore ways of leveraging health information exchanges (HIEs) and regional health information organizations (RHIOs).
- Standard letter to facilities explaining the purpose of and basis for a needed visit by public health in Maryland
- Coordination between health departments and HIEs / RHIOs in New York
- Toolkit for state and local health departments developed by Minnesota Department of Health to assess needs and readiness for health information exchange in today’s rapidly changing health information environment
- Oregon allows local public health departments to require healthcare providers or individuals with the necessary information for the investigation to release information to the state or local public health administrators (Oregon Statute 433.004)
- Virginia requires health practitioners and persons in charge of medical care facilities to permit the health commissioner or designee to examine and review medical records for disease investigation, and exempts those individuals from liability for permitting that examination and review.
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Information for this toolkit was collected through interviews with state health agencies and feedback from national-level stakeholders. See the methodology for more details.