ONC: Physicians lagged in sharing data with public health agencies

The agency’s latest ‘data brief’ highlights the lack of electronic data exchange with physicians’ offices and the need for better infrastructure.


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ONC: The COVID-19 pandemic exposed gaps in the nation’s public health infrastructure that hinder electronic reporting, suggesting the need to move from paper and manual reporting.

Only 12 percent of office-based physicians electronically exchanged patient health information with public health agencies in 2019, according to a new report from the Office of the National Coordinator for Health IT.

But as a result of recent challenges, several ongoing efforts aim to improve the flow of data to and from these agencies.

ONC hypothesized in its latest data brief, released August 18, that the low electronic exchange rates may be because, in part, that manual reporting methods, such as telephone, email and fax, were still allowed in many jurisdictions. Another key factor: Many public health agencies lack the capacity to electronically receive standardized data from office-based physicians.

The COVID-19 pandemic exposed gaps in the nation’s public health infrastructure that hinder electronic reporting and pointed to the need to move away from paper and manual reporting processes, the ONC also pointed out.  

Snapshot of statistics

Among the data brief’s other findings:

  • Electronic exchange capabilities were higher in 2019 among primary care physicians than those in other specialties.
  • The most common data electronically exchanged with public health agencies was immunization information.
  • Primary care physicians engaged in interoperability and those using certified health IT were more likely to electronically share data with public health agencies.
  • Physicians using electronic health records systems from health IT developers with large market share had the highest rates of data exchange with the agencies.

Ongoing efforts

Among the many ongoing efforts to improve electronic data exchange between providers and public health agencies are the ONC’s STAR HIE Program and the Centers for Disease Control and Prevention’s Data Modernization Initiative. Most of the ongoing initiatives were launched during or as a result of the pandemic and are just beginning to bear fruit, according to an ONC spokesperson.

Several programs, such as the Merit-based Incentive Payment System, have also added new requirements intended to increase electronic public health reporting rates.

In a related blog post, also released on August 18, Chelsea Richwine and Vaishali Patel from ONC’s Office of Technology stated that the latest study’s findings revealed a silver lining: physicians who electronically exchanged patient health information with public health agencies were significantly more likely to electronically record social (employment and education) and behavioral (alcohol and tobacco use) determinants of health – these can have a substantial impact on health risks and outcomes. The data on determinants can help support public health surveillance and aid populations disproportionately affected by the pandemic.

Richwine and Patel said that the data brief highlights the challenges to public health reporting, but they noted that ONC is taking steps to address the problem.

“Efforts underway at ONC and HHS more broadly aim to modernize public health data systems and promote the seamless exchange of information (including social and behavioral determinants of health data) among healthcare providers and public health agencies,” they wrote. “Together, these efforts will provide both the technical infrastructure and the incentives to better support key public health activities during the ongoing pandemic and in future public health emergencies.”


Marla Durben Hirsch is a freelance writer and editor specializing in healthcare and health law.

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