Assessing the Status and Prospects of State and Local Health Department Information Technology Infrastructure. Assessing the Status and Prospects of State and Local Health Department Information Technology Infrastructure : Table 11


: Table 11

SystemData Sources, Uses, & ManagementInterfaces and Data Capture
The Health Management System (HMS)HMS is a practice management system with EHR modules used in public health clinics. 11,000 registered users on 50 interfaces to manage encounter and services data entered by providers at LHDs. Includes registration, eligibility, scheduling, and care coordination. Additional modules include unified service reporting, billing, TB, HIV, Healthy Start, clinical encounter data, and dental. Most EHR modules are "homegrown," with a few that are off-the-shelf products (e.g.,) e-Prescribing.Interfaces with 4 other state systems and 14 external systems.
ADAP database for tracking HIV careReal-time enrollment information for HIV/AIDS clients inputted by eligibility staff at LHDs. Client-level data used in reporting to tie cost to each client, thus meeting reporting requirements. Displays medications prescribed by clinicians and indicates when the prescriptions are picked-up.Beginning to develop an ADAP module on CAREWare to integrate the two systems.
CAREWareCAREWare is open-source software that allows Ryan White Care Act recipients to document and report on care delivered to HIV/AIDS clients and produce the Ryan White HIV/AIDS Services Report to HRSA. Staff at LHDs and private providers treating the HIV/AIDS population covered under Ryan White enter client-level data.Health departments that provide HIV care must upload their data from CAREWare into HMS manually. Private providers enter data into CAREWare directly.
Enhanced HIV/AIDS Reporting System (eHARS)HIV/AIDS reporting system that states use to voluntarily report cases for surveillance to the CDC. Includes reports of positive HIV cases not only from public health clinicians but from patients served by all providers. Data reported directly from clinical laboratories using ELR.
MerlinThe state’s disease surveillance system. The system also tracks foodborne illness outbreaks. Public health clinics and laboratories report confirmed cases into Merlin. Data are maintained by the Bureau of Epidemiology in Tallahassee. System produces automated notification for LHDs about individual cases. Real-time aggregate data is available to the public online.Merlin is populated primarily through direct data input by LHDs or the ELR from clinical laboratories. Currently the system is not interoperable with HMS.
Patient Reporting, Investigation and Surveillance Manager (PRISM)Surveillance system used by state STD epidemiologists and STD clinic staff at LHDs. Positive lab reported automatically via ELR. STD clinics enter patient demographics, patient contact information, travel history and sexual contacts by name. STD surveillance functions include monitoring reporting timeframes for labs and providers, tracking volume of testing by lab and provider, tracking disease prevalence by area, county, disease, and selected dates, assigning field records to disease investigators, targeting providers to improve reporting. Produces disease reports on prevalence, common risk behaviors, shared demographics and geographic concentrations. Also generates automated text messages of test results for clients (opt-in). PRISM is a web-based system developed and maintained at FL DOH and currently used by multiple states.Fully integrated with the ELR from public health and clinical labs. Not currently integrated with HMS.
The Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE)The syndromic surveillance system used to identify outbreaks. It collects emergency department chief complaint data from hospitals and urgent care centers, call data from poison control, reportable disease data from Merlin and mortality data from the Florida Office of Vital Statistics. Used for outbreak detection, situational awareness monitoring and post-hurricane disaster surveillance. Produces graphics and summary statistic tables that LHDs use in their reports. State epidemiologists meet weekly to review trends discovered by ESSENCE.Receives data from the Merlin database and vital statistics records. Otherwise data are entered by hospital and urgent care facility staff.
Florida SHOTSFL SHOTS is the state’s immunization registry. Vendors include Bay systems, Vtech, Henry Elliot & Company, Advanced Systems Design. LHDs manually enter data into FL SHOTS. SHOTS experiences a very high number of electronic transactions. The registry is also a decision support system, providing information for managing immunization clinics and ensuring appropriate immunization levels. Providers can run reports and are able to generate reminder calls to bring children for scheduled vaccinations. Almost all LHDs use this function extensively. Public health staff downloads SHOTS data into the HMS system through a manual process.
SpecimenGateA PerkinElmer runs newborn screening system. Laboratory results reported via ELR. Physicians have ability to add information via e-reports add-on. FL DOH developed web-based system for physicians to access newborn screening results online-can produce a PDF copy of lab report to the physician.Working on consolidating newborn screening and vital records systems
Community Health Assessment Resource Tool Set (CHARTS)A data dissemination tool built in a web-based platform called DUNDAS. The program provides data visualizations incorporating data from multiple public health systems including vital statistics, Merlin, Medicaid, Department of Education, Department of Juvenile Justice, and the Behavioral Risk Factor Surveillance System (BRFSS). A web-based interface is available to the public. Generates reports and charts on various topics including such health statistics as births, deaths, disease morbidity, population and behavioral risk factors.Users can export data to MS Excel for analysis.
Environmental Health Database (EHD)Tracks inspection results, date of inspection, demographics, septic system or food facility owners, location, soils, sanitary nuisances at the local level.No active interfaces with other systems.