Recently passed federal legislation makes it possible for healthcare providers to share health data in a more efficient and timely way. The Health Information Technology for Economic and Clinical Health (HITECH) under the American Recovery and Reinvestment Act of 2009 (ARRA) contains incentives for healthcare providers and hospitals to accelerate the adoption of electronic health record (EHR) systems to improve patient healthcare. The NH Division of Public Health Services (DPHS) is working with healthcare providers, hospitals, and others including the New Hampshire Health Information Organization, the Regional Extension Center of New Hampshire and the NH DHHS Office of Medicaid Business and Policy, to receive the following standardized data from Certified Electronic Health Record Technology (CEHRT) for use in a meaningful manner to improve public health:
- Electronic Laboratory Reports (ELR) for reportable diseases and conditions;
- Emergency Department syndromic surveillance data; and
- Immunization data from EHRs.
Medicare and Medicaid Electronic Health Record Incentive Programs
The Medicare and Medicaid EHR Incentive Programs provide incentive payments to healthcare providers and hospitals as they adopt, implement, upgrade or demonstrate meaningful use of certified EHR technology. To learn more about the certification process, please visit The Office of the National Coordinator for Health Information Technology Certification Programs.
Reporting to DPHS for Meaningful Use
DPHS is currently accepting electronic syndromic surveillance data and electronic laboratory data from Eligible Hospitals. Updated information and guidance on participating with DPHS in meeting objectives and menu options under Meaningful Use is available:
- DPHS Meaningful Use Readiness Update, November 2014
- DPHS Meaningful Use Readiness Update September 2014
- DPHS Meaningful Use Readiness Update October 2013
Once a healthcare provider or hospital contacts DPHS with intent to establish an electronic connection for the transmission of health data (referred to as "onboarding"), DPHS staff will guide them through the onboarding process for their specific data reporting category. They will be provided with local implementation guides and other necessary documentation; and, upon agreement with DPHS, will set up an approved data transport (adhering to DPHS specifications) to send test data. Test messages will be validated by DPHS staff in a test environment. Once the message structure and content are deemed acceptable, data will be migrated to a production transport and feed.
Electronic Laboratory Reporting (ELR)
Electronic Laboratory Reporting allows hospitals to securely send laboratory data in a standard electronic format to report test results for diseases identified in the State of New Hampshire Reportable Disease List and Disease Reporting Guidelines to New Hampshire’s disease surveillance systems. ELR allows for more rapid reporting to DPHS and reduces the hospital’s reporting burden. The NH Local Implementation Guide for ELR Using HL7 2.5.1 provides specifications for facilities to use as guidance for reporting laboratory results electronically to DPHS. Electronic Laboratory Reporting provides an efficient and standardized manner of transferring individual laboratory results to DPHS. New Hampshire is ready to accept ELR data and will schedule testing and onboarding with hospitals over the next year as they express interest.
Important Note: ELR does not replace the statutory requirement for healthcare providers to notify the DPHS Bureau of Infectious Disease Control of diseases and conditions that must be reported within 24 or 72 hours of suspicion or diagnosis as mandated in New Hampshire Statute RSA 141-C and corresponding administrative rule He-P 301.
Syndromic Surveillance Data
Syndromic surveillance reporting and analysis of near real-time, de-identified encounter data enables early event detection of infectious disease and injury to control the spread of disease and reduce the risk of injury. Hospitals can meet meaningful use requirements for syndromic surveillance by submitting data to the DPHS syndromic surveillance system. The New Hampshire Local Implementation Guide for Syndromic Surveillance Reporting provides specifications for providers to use as guidance for reporting syndromic surveillance electronically to DPHS. Sending this data to DPHS will allow New Hampshire to contribute to the BioSense 2.0 web-based application for national and regional situational awareness.
One of the methods used to demonstrate meaningful use is the electronic exchange of immunization data from a certified EHR system to an immunization registry. Although New Hampshire is not accepting immunization data from CEHRT at this time, it is in the process of establishing an Immunization Information System (IIS). The IIS will consolidate all immunizations into a single record for each New Hampshire resident.
Cancer Registry Data
Another method used to demonstrate meaningful use is the electronic exchange of cancer registry data from a certified EHR system to a cancer registry. Although New Hampshire is not accepting cancer registry data from CEHRT at this time, providers should continue to complete and transmit a rapid report, as defined in He-P 304.04. NH DPHS anticipates accepting the submission of cancer case information from CEHRT beginning with the 2016 reporting period Calendar Year (CY) 2016