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March 5, 2014

The power of partnership: public health rises to the meaningful use 3 challenge

Last week, the Health IT Policy Committee’s Meaningful Use Workgroup made a decision that immediately caused a stir in the public health community. On Wednesday, the group voted to remove from meaningful use stage 3 many of the public health objectives, including syndromic surveillance and certification requirements for case reporting. This does not appear to be targeting public ehealth objectives specifically, but is part of an overall tendency to reduce the number of objectives for providers and hospitals in stage 3.

The removal of these objectives would prevent public health officials and agencies from obtaining data that shed valuable insight on public health needs. As a result, many in public health were concerned that this decision could kill a crucial and irretrievable opportunity to leverage the groundwork laid by meaningful use stages 1 and 2 to support public health objectives. Others worried that this decision may send out a message that public health concerns are expendable.

Within a matter of hours after the announcement of the workgroup’s vote, the public health community sprang into action. JPHIT (a consortium of major public health associations co-chaired by NACCHO and ASTHO) mobilized each of its 10 member organizations, also gathering together state and local officials and epidemiologists. Letters poured in from public health agencies and individuals, each enumerating the myriad problems inherent in removing public health objectives from Meaningful Use 3.  Dr. Art Davidson of Denver Public Health was particularly influential, giving a presentation that embodied his characteristic persuasiveness.

Together, this collective action coalesced into something that was impossible to ignore. After reviewing the response, the meaningful use workgroup changed its recommendations, voting to drop only syndromic surveillance for eligible providers from meaningful use 3. While not an ideal outcome, this loss is far preferable to the far more extreme measures recommended by the original vote.

This outcome highlights the power of public health when it takes a unified approach to push policies to transcend political pressure. When the public health community rises to the challenges it faces, it’s truly inspiring what can be accomplished. Thanks to the altered recommendations of the meaningful use workgroup, public health can continue to pursue the mission of sharing information to protect and promote both individual and population health.

David A. Ross, ScD

President/CEO of the Task Force for Global Health, former director of PHII