Getting the word out when the need for speed is critical to public health

April 3, 2009

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Critical public health messages can be delivered to clinicians throughout Marion County, Indiana, electronically via DOCS4DOCS®, developed by the Regenstrief Institute. Credit: Brian E. Dixon, M.P.H., Regenstrief Institute

When the need for speed is critical, how can a public health department communicate with doctors and hospitals, sending alerts to help prevent or stop a public health crisis? How can thousands of health-care providers be notified about disease outbreaks, illness from food borne contaminants or even a possible pandemic?

Researchers from the Regenstrief Institute, Inc. in collaboration with the Marion County Health Department (Indianapolis, Ind), have developed and tested a technology that allows public health officials to abandon a traditional, inefficient paper approach to alerting the medical community about public health crises in favor of an electronic strategy to seamlessly and instantly push out information critical to patient care.

Regenstrief is demonstrating its pioneering and potentially life saving technology to health care, government, public health, industry and other health information technology leaders at the Healthcare Information and Management Systems Society's (HIMSS) Conference and Exhibition April 4 - 8 in Chicago.

To enable instant delivery of public health alerts to physicians, Regenstrief health-care information technology professionals have created a web application that interfaces with their DOCS4DOCS® service, operated by the Indiana Health Information Exchange (IHIE).

DOCS4DOCS is a clinical messaging service that delivers more than one million messages with information, such as laboratory or other test results, critical to patient care to physicians and other care providers each day throughout central Indiana. The public health department will now be able to create a message and securely send that message via DOCS4DOCS to clinicians when and where they are likely to utilize the information to improve patient care.

Like most other public health departments across the nation, the Marion County Health Department has traditionally performed the public health alert function using a variety of methods, including news releases targeted to the public and posting letters to physicians. Postal delivery service can delay notification to primary care physicians by 72 to 96 hours - a critical time in which the opportunity to better serve patients has been lost.

"One of the best ways to stop disease outbreaks is to rapidly identify and treat the cases," said P. Joseph Gibson, MPH, Ph.D., director of epidemiology, Marion County Health Department.

"So when a public health department detects an outbreak, it is often important to rapidly notify all the doctors in the area, so they may increase their index of suspicion for the illness, and do more testing and treatment."

"Maintaining accurate contact information for doctors in a city the size of Indianapolis can be challenging. That's where the well-established DOCS4DOCS alert system will be advantageous. DOCS4DOCS maintains the system, so the health department is relieved of the effort of trying to keep their contact information up to date," said Gibson.

Home of the Regenstrief Medical Records System, one of the world's oldest electronic medical records systems, the Regenstrief Institute has been capturing and aggregating health-care data from throughout Central Indiana since 1994. Today metropolitan Indianapolis is the most health-care wired city in the nation.

"Our public health broadcast messaging initiative leverages Regenstrief's core standards-based health information exchange infrastructure in novel ways to improve the health of our community. By building on existing proven technology already used for clinical health care, we minimize development costs and rapidly implement technology that delivers real-world value to public health," said Shaun Grannis, M.D., Regenstrief Institute research scientist and Indiana University School of Medicine assistant professor of family medicine.

Last year Regenstrief investigators received a $10 million, 5-year contract from the Centers for Disease Control and Prevention (CDC) to accelerate the real-time ability of local, state and regional entities to share data and information to enhance rapid response to and management of potentially catastrophic infectious disease outbreaks and other public health emergencies.

"DOCS4DOCS is a robust, efficient communication system that can reach virtually all health-care providers in the Indianapolis metropolitan area. On a daily basis it provides essential information that facilitates and enhances clinical practice, and it also provides a superb platform for public health to send critical information to the medical community. It is a prime example of a bidirectional communication system that other communities should seriously consider for implementation," said Charles Magruder, M.D., M.P.H., senior advisor, Health Information Exchange Activities, National Center for Public Health Informatics at the CDC.

After further evaluation, Regenstrief plans to offer the new technology to other public health departments.

Source: Indiana University (news : web)