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Public health agencies have a long-standing tradition of engaging with the citizens in their jurisdictions over matters relating to both individual and population health. But when it comes to data, most public health agencies are focused primarily on collecting data from healthcare providers (both when mandated and when voluntary), and returning data when appropriate back to those providers. Some agencies have begun to publish aggregate data about a community’s health based on data collected from a variety of sources (for a good example of this see the Healthy Communities Institute).
[Commentary: On advocacy, coordinated care, and the patient directive.]
But a new age is dawning. The Office of the National Coordinator for HIT has launched a new effort focused on consumer health. Dubbed “Putting the I in HIT” this initiative is trying to engage consumers and explain how health IT affects them and how it can help them. Some prominent early examples come from the world of public health:
- Blue Button: Major Federal healthcare providers (VA, DoD, Medicare) have begun providing the capability for patients to download an electronic version of their healthcare records through a single click of a “blue button” on the respective websites. This has now become a metaphor for easy access to personal health records.
- Health Insurance Exchange: A key component of the Affordable Care Act is the creation of a marketplace where consumers can shop for health insurance. The Federal government has provided funding to states to set up these online sources of information and many are in the planning stage now.
- Immunization Information Systems (IIS): Though primarily focused on collecting data from providers and presenting consolidated immunization histories in return, IIS projects have begun to establish patient portals mostly for parents to look up their children’s histories and generate a summary for school, child care, or camp without needing to visit a physician. Both Wisconsin and Nebraska offer this option. Others will certainly follow.
Use of personal health records (PHR) will continue to rise over the next several years as more health information is available electronically. Initially, use of tethered PHRs will dominate – these are systems offered by individual health plans or provider organizations with data populated from institutional sources only. Over time, as tools get easier to use, patients will begin to populate untethered PHRs which will consolidate data across sources. It is important for public health to recognize not only its current role, but to contemplate its future role in these game-changing activities.