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Various technical challenges affect hospitals’ ability to fulfill public-health reporting obligations

Blog | Technology

Various technical challenges affect hospitals’ ability to fulfill public-health reporting obligations

A report issued by a federal agency finds many hospitals struggling to exchange data electronically with public health agencies.

Hospitals face several obstacles in attempting to meet public-health reporting requirements, according to a report by the Office of the National Coordinator for Health Information Technology.

The report was based on 2018 and 2019 survey responses in the American Hospital Association’s Information Technology supplement, meaning it’s a look at the pre-pandemic reporting landscape.

“While new challenges may have emerged or become exacerbated during the pandemic, this analysis identifies potential ongoing barriers to health information exchange among hospitals and public health agencies and provides insights into hospitals’ readiness to support key public health activities prior to the pandemic,” the report states.

Biggest challenges in public health reporting

Half of hospitals in 2018 and 2019 reported difficulty related to the electronic exchange of data with public health agencies. The two most frequently cited issues were:

  • Lack of capacity (e.g., technical, staffing) to exchange information electronically
  • Interface-related issues (e.g., costs, complexity)

Not surprisingly, small, rural, independent and critical access hospitals were more likely than other hospitals to run into obstacles, although issues regarding a lack of capacity were prevalent across hospital types.

Issues that were more common for small, rural, independent and critical access hospitals than for other hospitals included:

  • Interface-related issues
  • Difficulty extracting relevant information from the EHR
  • Confusion about where to send information to meet requirements

The report calls out that regulations published in 2020 introduced two new technical certification criteria, which were designed to improve the exchange of electronic health information using certified health IT systems.

“While both of these certification criteria are intended to facilitate patients’ access to their health information and interoperability among clinicians, these functionalities can also support public health reporting,” the report states. The criteria pertain to the exporting of electronic health information and standardized application programming interfaces for patient and population services.

A potential workaround: HIE membership

Participation in a health information exchange was associated with lower probability of experiencing some of the challenges related to public health reporting, including difficulty extracting information from the EHR and confusion about where to send information.

“Studies have shown that HIEs can support hospitals and public health agencies by addressing gaps in missing information, supporting public health reporting and monitoring, and providing other data services to help enable exchange,” the report states.

Federal funding is available to bolster HIE networks nationwide, the report notes.

About the Author

Nick Hut

is a senior editor with HFMA, Westchester, Ill. (

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