The first year of Stage 2 Meaningful Use requirements is coming up fast (October, 2013). Meaningful use participants will need to achieve ongoing submission of public health reports to health departments. A multi-organizational taskforce has issued guidance materials for local and state health departments to help them 1) declare their readiness to receive data from eligible professionals (EPs) and hospitals (EHs); 2) establish systems whereby EPs and EHs register their intent to submit data; 3) on-board data submitters; and 4) provide necessary acknowledgement of on-going data submission. That’s a lot to get ready for! (Some health departments are also acquiring electronic health record (EHR) systems and will themselves need to demonstrate that they are meeting other Meaningful Use objectives as well.)
Unfortunately, as in earlier years, the President’s FY 2014 proposed budget fails to include dedicated funding to help health departments exchange information with EHR systems (with the notable exception of the National Healthcare Safety Network, which is not part of Stage 2 Meaningful Use regulations). State health departments are heavily dependent (45%) on federal funding, especially from the Centers for Disease Control and Prevention (CDC). While several CDC funding programs encourage recipients to use funds for achieving connectivity for Meaningful Use Population and Public Health objectives, CDC’s proposed budgets for programs that would support meaningful use objectives (like immunization and emergency preparedness) would shrink in 2014. Health departments may indirectly benefit from increased funding for ONC if it facilitates health information exchange, and in a few states partial funding for public health information exchange is addressed in state Medicaid plans. Most affected health departments will need to make do with existing or shrinking resources as Stage 2 ratchets up expectations.
The ONC’s budget proposal (page 33) seems to suggest that ONC is establishing a dashboard of public health participation in meaningful use information exchange. This would be an important indicator for policy-makers and public health advocates to watch.