- One prong of the Triple Aim targets improving the health of populations, part of the impetus behind public health reporting requirements under the EHR Incentive Programs.
However, meaningful use hospital data compiled and published by the Office of the National Coordinator for Health Information Technology indicate disparities across the nation for the three public health reporting meaningful use requirements in Stage 1 and Stage 2 Meaningful Use.
To set the table, the three public health reporting requirements in the EHR Incentive Programs are immunizations, reportable lab results, and syndromic surveillance.
The first measure is the percentage of all hospitals nationally and by state that attested to reporting immunization or vaccination data to a local public health agency. The second is the percentage of all hospitals nationally and by state that attested to reporting reportable lab results data to a local public health agency. Lastly, the third is the percentage of all hospitals nationally and by state that attested to reporting syndromic surveillance data to a local public health agency.
A note on the data: These figures represent successful attestations to the Medicare EHR Incentive Program for fiscal years 2013 and 2014. Public health reporting has an increased presence for proposed Stage 3 Meaningful Use requirements, but recent changes to the program as a result of the Merit-Based Incentive Payment Program could very well change that.
On the whole, the national averages for meaningful use hospitals reporting at least one public health measure were 86 percent and 85 percent in 2013 and 2014, respectively. The highest performing states were Delaware, Utah, Maryland, Wisconsin, and Florida based on an average of the two reporting years.
Coming in on the opposite end were Vermont, Colorado, Wyoming, Connecticut, and Kansas. As the data show, both Vermont and Wyoming managed to make significant headway between 2013 and 2014.
The national averages for immunization were 62 percent in 2013 and 73 percent in 2014. This was the measure most reported by eligible hospitals for which Stage 1 Meaningful Use required at least one reported measure.
The top performing states were Kentucky, Alaska, Utah, Minnesota, and Idaho. Four out of the five saw a decrease in hospital percentages reporting this measure between 2013 and 2014.
Coming in on the low end were Nevada, Connecticut, the District of Columbia, New Hampshire, and North Carolina. All except DC saw drop-offs between 2013 and 2014.
The national averages for reportable lab results show room for improvement across the board: 17 percent in 2013 and 47 percent in 2014. The top-five in this category — Massachusetts, Montana, Washington, Maine, and Indiana — saw increases in eligible hospital reporting of this measure in 2014.
As for low-performing states, the numbers aren't good. Only Oklahoma managed to reach double digits, with the remaining states having single-digit percentages.
The national averages for syndromic surveillance were highly, but only slightly — 21 percent in 2013 and 48 percent in 2014.
New Hampshire, North Carolina, Hawaii, Indiana, and New Jersey led the way in this category.
Meanwhile, the likes of Oklahoma, Tennessee, Minnesota, Connecticut, and Iowa brought up the rear.
For the health of populations to improve, hospitals must possess themselves the ability to report on these measures and have access to public health agencies capable of receiving these data. The data, however, provide no insight.