Physicians, public health agencies exchanging more information electronically

Increasing numbers of primary care physicians (PCPs) shared medical information electronically with public health agencies (PHAs) in the year before the COVID-19 pandemic.

They also began logging more data about social and behavioral determinants of health for patients, according to the survey examining electronic communications between physicians and PHAs, published by the U.S. Department of Health and Human Services.

“The COVID-19 pandemic revealed significant gaps in public health infrastructure needed to support the electronic exchange of public health data among health care providers and PHAs,” said the report published by the Office of the National Coordinator for Health Information Technology.

The data are important for at least two reasons: public health surveillance and identifying populations in need of greater assistance due to social and behavioral determinants of health, the report said.

The researchers noted the study did not cover overall reporting rates to PHAs, and other recent studies showed PCPs are reporting to PHAs through paper-based data sharing, telephone calls, emails and facsimile machines.

Trading data

Fewer than one in five PCPs electronically sent or received health information with PHAs. For all physicians, 12% electronically exchanged information with the federal Centers for Disease Control and Prevention (CDC), or state or local health authorities.

The rates were greater or equal for pediatrics (26%), internal medicine (24%), primary care, (18%) and general/family practice (12%). In those fields, at least 46% said they did not exchange information electronically, and at least 22% of physicians said they did not know if they did, according to the report.

Seeking vaccinations

Nationally, 44% of PCPs reported searching for vaccination or immunization history from sources outside their own health care organizations. The percentages increased for internists (53%) and pediatricians (51%), compared to 41% of general/family practices PCPs.

Exchanging immunization data was the most common for all primary care physicians (90%), pediatricians (100%), internal medicine physicians (82%) and general or family practice (89%). Case reporting data, public health registry data, and syndromic surveillance data all were exchanged at lower rates by the various physicians, the report said.

Practice size

PCPs in larger practices, those in hospital or health-center owned practices, and those able to send and receive patient data electronically, were significantly more likely to exchange information with PHAs. Those that exchanged data with PHAs, and those that searched for vaccination or immunization information from outside sources, were significantly more likely to electronically record social and behavioral determinants of health, the report said.

Most physicians (69%) electronically recorded data about social and determinants of health, such as employment, education, and social and community context that affect health and quality of life outcomes. For behavioral determinants of health, such as alcohol and tobacco use and physical activity, 84% of physicians recorded data electronically.

Primary care physicians were significantly more likely to electronically record social and behavioral determinants of health, compared to specialists. Physicians using EHR developers in the top five for market share had the highest rates of sharing and recording patient data electronically, compared to those using EHR developers without a top 10 market share, the report said.