In the previous spotlight, we learned about the importance of data sharing to support outbreak response and some of the challenges public health and healthcare professionals face. Here, I will highlight Snohomish County Health Department’s (SCHD) lessons learned and strategies for successfully gaining access to electronic health records (EHRs) of healthcare system partners within our jurisdiction and how it streamlines our case reporting, outbreak detection and response, and case investigations.
SCHD, based in Washington State, developed close relationships with healthcare organizations (HCOs) during the pandemic which were elemental in gaining access to our jurisdiction’s HCO’s EHRs. The pandemic also emphasized the benefits of public health having direct EHR access. Direct access helps streamline a process that can be confusing and burdensome for HCO staff. Previously, this type of information exchange could involve multiple rounds of faxes or phone calls.
When we reach out to pursue a new EHR access agreement, my colleagues and I have conversations with the HCO’s executive/c-suite leaders to identify their concerns. We underscore our willingness to support the data sharing agreement process and its flexibility regarding potential HCO requirements, such as limiting public health account access to requesting specific types of patient information or records. This establishes a basis to build trust from which growth can occur, with the long-term goal of gaining full read-only access to all HCO partner EHRs as is allowable under HIPAA and public health law. With these foundational relationships, LHDs can expand data sharing opportunities to improve community health.
Another strategy SCHD has leveraged was to first target the HCOs with the lowest barriers to EHR access for both public health and healthcare providers from different systems. Once we had multiple HCOs that granted access, it was easier to persuade other organizations that were more hesitant. We also worked internally to identify the HCOs for which EHR access would be most beneficial to our disease and outbreak investigation work.
Snohomish County also recommends a proactive approach in which EHR access is obtained prior to outbreaks and relevant accounts are ready to go. We’re hopeful that our experience implementing these strategies serves as a learning opportunity for other jurisdictions to establish data sharing agreements with their HCOs.
James Lewis