Learning from newborn hearing screening electronic data exchange among hospital and ambulatory clinical care and public health information systems

Early Hearing Detection and Intervention (EHDI) is one of the most innovative public health vanguard programs demonstrating the potential of electronic data exchanges between clinical care and public health agency information systems. This work involves using standards-based clinical decision support tools and advanced nationally-endorsed electronic quality measures.  While addressing the unique needs of deaf and hard of hearing infants and their families, EHDI efforts designed for bidirectional electronic information exchange are improving the capacity of public health programs to ensure that all newborns in their jurisdiction receive timely and appropriate services.  A Health Level Seven (HL7) Draft Standard for Trial Use (DSTU) implementation guide has been published by the Public Health and Emergency Response (PHER) workgroup that standardizes the transmission of newborn hearing screening data elements from screening equipment to health information systems.  One of the nationally endorsed population level electronic health measures (eMeasures) specifically developed for EHDI is now included as one of the 29 Clinical Quality Measures that hospitals may choose to report in order to qualify for Stage 2 of the Centers for Medicare & Medicaid Services (CMS) Electronic Health Record (EHR) Meaningful Use incentive program.  EHDI pilot projects have demonstrated the use of Clinical Document Architecture (CDA) as a method to transmit clinical information in a format that is structured for both human readability and computer processing.  EHDI can be used as a model to promote the adoption and effective use of electronic information exchange among hospitals, providers and public health, thereby  establishing one of the first meaningful interoperability opportunities in an individual’s lifetime and providing an opportunity to lay the foundation for a public health role in Electronic Health Record) clinical information exchanges.