Editorial: Vol 2, No 2 (2010)

The major challenges facing the U.S. healthcare systems are escalating costs, lack of access to almost 40 million residents, and inconsistent quality. It is hypothesized that the use of electronic health records systems and the implementation of interoperable health information exchanges (HIE) will result in significant cost savings, outcomes and quality improvement, reduction in medical errors and redundancies, and the enhancement of public health and disease surveillance. HIEs are organizations that facilitate secure health data exchanges among consenting and authorized stakeholders. The ultimate result of the current unprecedented increase in the investment in health information technology is the transformation of the U.S. Healthcare system. In order to achieve such a transformation and the attendant benefits the Health Information Technology for Economic and Clinical Health Act (HITECH) of the American Recovery and Reinvestment Act of 2009 allocated over 30 billion dollars to the states to encourage the use of electronic health records and develop interoperable health information exchanges. What is the public health case for participating in the implementation of the health information exchanges? The occurrences of major public health threats in recent years have highlighted the need for integrating public health data sources and surveillance systems into the emerging health information exchanges. Such an integrated system will facilitate the timely distribution and sharing of relevant health data across the various stakeholders such as public health practitioners, clinicians, and policy makers, and payers. Data sharing will improve the situational awareness operations of the stakeholders and lead to improved decision making regarding the control of emergencies, treatment of individual cases, and efficient resource allocation. If public health practitioners are aware of the critical events in a region but the information is not available to clinicians at a place and time when it could be utilized, then the information is of limited value. To encourage the adoption of HIE-supported situational awareness among healthcare stakeholders the Centers for Disease Control and Prevention (CDC) awarded three HIE grants to recipients from Indiana, New York, and Washington State-Idaho. The awardees were charged with investigating and developing methods for sharing information between public health and clinical practitioners to support situational awareness and case reporting. This special issue of the journal is dedicated to disseminating the achievements of the awardees in terms of articles published, conferences attended, technologies implemented, and lessons learned. THE Indiana coalition (made up of University of Indiana, Marion County Health Department (MCHD), and Regenstrief …