SCALING HEALTH INFRASTRUCTURE

Advancing Public Health Through Innovative Vital Records Interoperability 

The fields of public health and epidemiology gained momentum in the  late 1800’s in the United States, as data tracking illuminated the profound impact of sanitary conditions on health outcomes. Over the past century, public health data collection has evolved significantly, yet challenges continue to arrive from outdated processes and technology, coupled with limited interoperability across various public health jurisdictions, providers, and community programs.

Altarum’s Public Health Systems team has been leveraging our Fast Healthcare Interoperability Resources (FHIR), Rhapsody, and overall interoperability development and implementation expertise to help organizations like the Centers for Disease Control and Prevention (CDC) and state departments of public health modernize their systems. We’re increasing both the speed of data delivery and trust in the completeness and accuracy of the information being delivered to and from state public health to federal reporting systems.

Nationwide initiatives are underway to revamp the collection of vital statistics, exemplified by the CARES Act of 2020, which allocated $75 million towards modernizing the National Vital Statistics System (NVSS). This initiative includes the implementation of FHIR-based connections between jurisdictions’ electronic data registration systems and the CDC’s National Center for Health Statistics, facilitating quicker and more automated sharing of vital statistics between state and national levels.

Significant strides have been made in death records reporting. The CDC reports that around 2.6 million U.S. deaths undergo analysis annually via the NVSS. Notably, in 2023, 63% of these deaths were reported to the CDC within 10 days, marking a notable increase from the 2010 figure of 7%. It’s worth highlighting that the ultimate objective for all jurisdictions is to promptly report registered deaths to public health agencies within a single day, emphasizing the ongoing commitment to enhancing the efficiency and timeliness of vital statistics reporting nationwide.

An example of Altarum’s impact on this initiative is our partnership with the Michigan Department of Health & Human Services (MDHHS) and state registrar. Together, we are actively involved in updating processes and systems for transmitting death records to the state registry, as well as pioneering the development of Rhapsody FHIR APIs to deliver aggregated near real-time data to the NVSS. These data serve diverse purposes, from detecting public health emergencies to supporting awareness campaigns and preventing fraudulent payments, benefiting public health organizations, payers, and providers alike. By leveraging FHIR to streamline data input into the registries, we ensure that end users receive critical data faster.

In a significant recognition of Michigan’s commitment to advancing public health informatics, the Division of Vital Records and Health Statistics (DVRHS) at MDHHS has achieved certification for Mortality FHIR with the CDC’s National Center for Health Statistics (NCHS). This achievement, made possible through the implementation of Altarum’s Electronic Death Registration FHIR Messaging System solution, underscores Michigan’s leadership in leveraging cutting-edge technology to enhance public health outcomes. This recognition not only validates Michigan’s commitment to innovation but also highlights the state’s pivotal role in driving advancements in public health informatics.

Sandra Marshall, Director of Public Health Interoperability at Altarum, expressed her pride in the team’s accomplishment, stating, “I am incredibly proud of our team for their dedication and hard work in guiding MDHHS to this certification. This coordinated accomplishment reflects our commitment to driving innovation and excellence in public health IT, and I am confident that it will contribute to our collective efforts to improve health outcomes for all.”

By harnessing data from EHR systems and facilitating seamless communication with other health IT systems, Altarum contributes significantly to the collection and dissemination of vital health information. Our efforts bolster the trustworthiness and accuracy of vital birth and death data, while the adoption of FHIR standards ensures swifter access to this data. This, in turn, enables downstream organizations to leverage data effectively for public health interventions, epidemiological research, and a comprehensive understanding of health care dynamics.