The Strengthening the Technical Advancement & Readiness of Public Health via Health Information Exchange Program (The STAR HIE Program) is a $5 million cooperative agreement program that is designed to strengthen and expand the ability of health information exchanges (HIEs) to support public health agencies in their response to public health emergencies and pandemics such as COVID-19.
The program is designed to build and improve health information exchange services that benefit public health agencies and better support communities disproportionately impacted by the COVID-19 pandemic. The program was designed with two objectives in mind:
- Build innovative HIE services that benefit public health agencies.
- Improve the HIE services available to support communities disproportionately impacted by the COVID-19 pandemic.
Program Funding
On September 30, 2020, with $2.5 million in funding from the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), ONC awarded five cooperative agreements under the STAR HIE Program.
In January 2021, an additional $2.5 million in CARES Act funding was awarded to 17 additional HIEs to support efforts to increase data sharing between jurisdictional Immunization Information Systems (IISs) and HIEs.
This funding builds upon previous and existing federal investments in HIEs. Activities may include, but are not limited to:
- Identifying high-risk patients who have not yet received the vaccination.
- Improvements to the methods used for tracking and supporting COVID-19 vaccination administration.
- Supporting public health monitoring of long-term health effects of the vaccine across entire populations.
- Supporting public health efforts to monitor adverse vaccine reactions and reinfection rates.
- Real-time reporting of hospital capacity data.
Project Title: NYC Regional Health Information Exchange-enabled Response and Recovery (HIERR).
Bronx RHIO is working collaboratively with the NYC Department of Health & Mental Hygiene (DOHMH) and NYS Department of Health (DOH) to expand its infrastructure and services to address ongoing COVID-19 related needs and prepare for other public health emergencies in the future. This work is creating the NYC Regional Health Information Exchange-enabled Response and Recovery (HIERR).
Expansion of our HIE infrastructure includes new tools that will enable better surveillance and contact tracing to contain spread of the virus and track vaccination activity, support ongoing knowledge enhancement for policy making and intervention, and provide public health and provider staff with actionable information about the COVID-19-related status of their populations.
Project Title: Connecting Immunization Information Systems (IIS) and the Camden Coalition Health Information Exchange to support COVID-19 Vaccination in Southern New Jersey.
The Camden Coalition was awarded funding from the STAR HIE Program to coordinate with the New Jersey IIS and establish a process for receiving and ingesting COVID-19 vaccination data into its regional HIE.
Connecting the Camden Coalition HIE to NJIIS will provide real-time information on vaccinations, which participating providers can use alongside existing longitudinal healthcare and social risk factor records, including COVID-19 testing data, to best tailor their support of individual patients. Inclusion of vaccination data will further allow the Camden Coalition to generate and share reports that flag individuals who have not yet been vaccinated and have evidence of risk factors such as age, race/ethnicity, chronic conditions, social vulnerabilities, and existence of an established primary care relationship.
This will enable providers and vaccination sites to better target outreach to high-priority individuals and communities.
Project Title: HIE services that benefit public health agencies to support communities disproportionately impacted by the COVID-19 pandemic via the expansion of the Colorado Health Observation Regional Data System.
As the largest of two Colorado state health information exchange organizations, CORHIO performs at the service of the public health entities delivering clinical data to better the health of Colorado communities. The COVID pandemic has served as just one of several use cases where CORHIO was able to deliver targeted healthcare data to first responders and other groups as well as visualize that data to our COVID-19 analytics dashboard. With regards to the COVID-19 dashboard, CORHIO initially focused specifically on lab results: positive, negative, or unknown and later added vaccine data received from healthcare partners in the community.
While working with the Colorado Department of Public Health & Environment (CDPHE), CORHIO was able to engage at the policy level to collaborate on shared goals and evaluate state governing statues by gaining agreement on what the law requires. This shared understanding has allowed dialogue between the state agency and CORHIO with regards to the benefits of sharing data, deidentified or otherwise, for the sole purpose of protecting the public. COVID-19 is just one case where this creates a sense of urgency. The STAR program has allowed for visibility into other emergent situations affecting the public at large. Advancing technologies, connecting to public health agencies, and sharing clinical data in a secure manner to meet industry HITRUST standards in a way that supports public health agency and community priorities, defines CORHIO’s goals and initiatives.
Project Title: Strengthening Public Health Infrastructure for Public Health Surveillance.
Contexture (Health Current) is leading an Arizona Master Person Index Planning Collaborative. In conjunction with the Arizona Department of Health Services and Arizona’s Medicaid agency, Arizona Health Care Cost Containment System, a critical public health infrastructure need that was identified is a statewide master person index (MPI) that ties together multiple public health registries and Arizona health & human services state agencies.
Governor Ducey signed SB1505 that included several HIE-related provisions, including permission to allow COVID-19 immunization data to be shared with the HIE and utilized in alignment with statutory provisions. This action allowed Health Current to provide critical data to its participants during the public health emergency related to the COVID-19 pandemic. Read more
Project Title: Prioritizing Public Health Infrastructure Through an API Ecosystem: Living out the National Health Technology Priorities.
CyncHealth will demonstrate how HIE services can better support public health departments and hospitals in monitoring and reporting requirements for the COVID-19 response. We will partner with the State NESIIS system to modernize from a unidirectional feed from the HIE to NESIIS to a bi-directional connection. This will allow the ingestion of IIS data to augment data completeness, merger of disparate data sources including HIE, PDMP, STAR, ELR and other referential data sources and identification of high-risk patients who have not yet received vaccination by record-linkage across NESIIS, HIE, and vaccine information from pharmacy dispensed data.
CyncHealth will also use an automated approach for cohort selection and to identify an algorithm to define the risk-factors and integrate with public health workflow, to alert/track/monitor through registries or an API endpoint towards COVID-19 vaccination. This will allow the ability to look at a patient-record in 360 degrees to help support clinical and population.
Project Title: Expanding Public Health Reporting and Data Enrichment for At-Risk Populations: VA Facilities, State Corrections, and Unconnected Health Systems.
GaHIN will support the Georgia Departments of Public Health (DPH) and Community Health (DCH) to better access, share, and use electronic health information, especially data from populations underserved and/or disproportionately affected by the COVID-19 pandemic.
The State of Georgia has established a COVID-19 Registry under an interagency agreement between DPH and DCH. As the bi-directional gateway among state agencies and providers, GaHIN is actively contributing data to that registry.
This project consists of two activities to increase and enhance reported data. The first is to increase the reporting of results to this and other public health registries from targeted populations. The second is to enhance the value of the reported data by combining electronic lab results with demographic and other clinical data from across GaHIN’s broad network. GaHIN has plans to expand Public Health Reporting and Data Enrichment for at-risk populations that are currently not connected to GaHIN and therefore not contributing COVID-19 data for public health: Veteran’s Affairs facilities, State Corrections facilities, and Unconnected Health Systems (i.e., hospitals and facilities).
Project Title: Leveraging Greater Houston Healthconnect for Situational Awareness of COVID-19 Vaccination Efforts in Southeast Texas.
Greater Houston Healthconnect, HIE for Southeast Texas, is deploying its STAR HIE Program funding to help Public Health officials monitor and track COVID-19 vaccine distribution in the region. As COVID-19 vaccines are rolled out across this region, a pressing need exists to monitor adverse reactions, measure vaccine efficacy, and provide situational awareness.
Ultimately, Healthconnect’s efforts will provide public health officials will critical real-time information so they can make more informed decisions on vaccination efforts in Texas communities.
Healthconnect will leverage the power of its robust data platform, thousands of connected healthcare providers, and over 10 million patients in its clinical data repository to provide surveillance on COVID-19 vaccination efforts. In partnership with public health partners, Healthconnect will integrate COVID-19 immunization information into the HIE, enabling population health efforts including: 1) Identifying high-risk patients who have not yet received the vaccination; 2) Monitoring vaccine efficacy, adverse reactions, and reinfections across entire populations; and 3) Provide state-wide COVID-19 vaccination reporting to municipal, county, state, and federal public health authorities.
Project Title: Bi-directional Public Health Lab and HIE Connectivity Project.
HealtheConnect Alaska (Alaska state designated HIE), and CRISP Shared Services (who also is partnered with the West Virginia HIE) will leverage their collective expertise to demonstrate how HIE services can better support public health departments and hospitals as they execute state and federal reporting requirements for the COVID-19 response. Through this partnership, data will be incorporated into the HIE for query purposes, leveraged for Event Notifications and to supplement vaccine information with data sources and analytic tools that provide insights for public health officials and policymakers. This will make data accessible to providers and improve patient outcomes and reduce costs.
Project Title: Project Title: HEALTHeSENTINEL: HIE Platform for Improving Public Health Response.
HEALTHeLINK is a collaboration among hospitals, physicians, health plans and other health care providers in the eight counties of western New York State to securely exchange clinical information to improve the quality of care, enhance patient safety and mitigate health care costs. It enables providers to access their patients’ data from across the state.
As part of the STAR HIE project, HEALTHeLINK will be developing technologies to evaluate the COVID-19 immunization status for Western New York patients, risk stratify those most at risk who haven’t received the vaccine, providing ongoing monitoring of patients who have received the COVID-19 vaccination, including identifying patients with an emergency department or hospital admission within seven days of immunization; identification of patients with a positive COVID-19 test within 60 days of immunization; and, other monitoring criteria to be determined. In addition, HEALTHeLINK will deliver alert notifications to participating providers related to their patients’ immunization status, hospital admissions and COVID-19 test status.
Project Title: Project Title: Improving Data Quality to Assist Public Health Agencies with Contact Tracing.
The HealtHIE Nevada team proposes to enable broader access to COVID-19 (and other) vaccination information electronically and facilitate closing of the vaccination gaps in the general and underserved populations throughout Nevada. HealtHIE Nevada will collaborate with the Nevada Department of Public and Behavioral Health (DPBH) and their Immunization registry (WebIZ) to seamlessly push up-to-date vaccine information to participating practice’s EMR systems, and provide reporting to help primary care practices identify their patients who have not been vaccinated. The solution will make extensive use of previous investments, including existing practice connections (to generate rosters of patients to report on) and the existing WebIZ query interface (provided by a previous 90-10 grant), to orchestrate query batches against WebIZ.
These query batches will be used to both summarize a practice’s population immunization status and to provide the data to populate the connected EMRs, so that they can monitor their own population’s immunization status. The target practices will be those with primary care responsibilities, with special attention paid to FQHCs and other clinics that support underserved and Medicaid populations in the state.
Project Title: Leveraging Health IT Strategies for Delaware Valley Public Health Agencies.
HSX, one of the most robust HIEs in the United States, is the Delaware Valley’s HIE covering Pennsylvania, New Jersey, and Delaware. Over the course of two years, HSX will establish services benefitting public health agencies in their fight against COVID-19, as well as future communicable diseases, and improve services to support communities disproportionately impacted by COVID-19.
HSX will modernize the region’s pandemic response by exchanging data in real-time; facilitate public health agency use of the Delaware Valley COVID-19 Registry; create a dashboard of emergency department and inpatient volumes for the Philadelphia Department of Public Health and the Office of Emergency Management and create new clinical data connections. These new data connections include Electronic Lab Reporting (ELR) feeds to local and state agencies, connecting to the American Public Health Laboratory AIMS platform for Electronic Initial Case Report (eICR) communicable disease reporting, implementing new CCD feeds, and immunization data sharing.
Through this program, HSX aims to serve as a ready source of immunization status, provide priority rosters to public health agencies, monitor for vaccine-related adverse events, monitor for vaccine effectiveness, and monitor for racial disparities in vaccination.
We intend to enhance our infrastructure with new capabilities and add new data feeds that will fill many of the current gaps in public health surveillance systems.
Project Title: Connecting Underserved Communities to Address Indiana’s Excess Deaths and Disparities.
IHIE will collaborate with the Indiana Department of Health (IDoH), to leverage the extensive amount of clinical data held by our HIE to support enhanced knowledge sharing around the COVID-19 vaccinations. Particular attention will be focused on identifying data for high-risk, low-income, minority, and underserved populations, which have been disproportionally impacted by COVID-19. From the HIE clinical repository it will draw demographic, (age, race, ethnicity, and sex), payor (Medicaid as proxy for poverty status), and clinical data on chronic disease comorbidities. IHIE will combine with testing and vaccination rates from the state’s IIS, CHIRP, to identify our state’s most vulnerable communities disproportionately impacted by the COVID-19 pandemic. Using the COVID-19 immunization data collected in CHIRP, IHIE will create reports to track the rollout of the vaccine.
This work will complement current state dashboards, and other data visualization products provided by the Regenstrief Institute. Reports will serve for both 1) population monitoring and targeting purposes for the IDoH and local health departments, to complement other state resources, and 2) Patient-level coordination and vaccine promotion for providers serving primarily high-risk, low-income, minority, and underserved populations, which have been disproportionally impacted by COVID-19. https://www.ihie.org/vaccination-data-by-county/
Project Title: Building the Nation’s Electronic Infrastructure to Respond to COVID-19.
To effectively respond to the COVID pandemic, health IT infrastructure must be in place to transport data quickly and effectively to public health and ensure healthcare providers have the medical information to provide safe and effective care. This requires ongoing monitoring of patient’s COVID-19 virus activity and a simple method of providing this information to providers and the public health authorities responsible for decision-making.
To achieve this, three critical problems have emerged that KONZA is addressing during the two-year cooperative agreement project period:
- Provide ambulatory providers with an infrastructure to share COVID-19 lab results with public health using HL7v.2.1 standard (compliant with state e-lab reporting).
- Create an alerting platform to provide real-time COVID-19 information for population health to the Kansas Department of Health and Environment and build a new analytics dashboard with COVID diagnosis, lab results and vaccines for patients.
- Onboarded over 50 facilities in 2021 to participate in health information exchange and send data to the public health registries, essential for COVID-19 sharing health information with other providers and public health.
Project Title: Connecting Pennsylvania Immunization Information Systems and Enhancing Analysis Through Health Information Exchange.
KeyHIE, a non-profit regional HIE currently serving over 57 Pennsylvania counties, will quickly enhance communication of COVID-19 vaccination data with the Pennsylvania Department of Health (PA DOH) Pennsylvania Statewide Immunization Information System (PA-SIIS) and patients’ care team members.
KeyHIE will also assist PA DOH in tracking COVID-19 vaccinations via a heat map that will track the progress of vaccine distribution and identify areas that might impede the vaccine rollout. The project consists of three parts to accomplish the objectives:
Part 1: Send HL7 VXU messages containing COVID-19 vaccination information to PA-SIIS.
Part 2: Send COVID-19 vaccination information to Care Team Members
Part 3: Receive a deidentified CVRS file from PA-SIIS to create statewide vaccination heat map
Project Title: Strengthening Referrals in the City of Detroit for Technical Advancement and Readiness of Public health via the Michigan Health Information Network.
MiHIN, working with Patient Education Genius (PEG), has been able to leverage existing statewide infrastructure including our existing immunization use cases, which are sending immunizations to statewide registry (MCIR) and query statewide registry for immunization history and forecast, to offer a history forecast at the point of injection to ensure a patient is not getting multiple vaccinations, via a QBP message. This has been completed by working with the City of Detroit public health department to capture at the site of immunization, the patient information, and the lot number (date and time) the immunization took place for VXU message to send to the state immunization registry (MCIR).
As of September 6, 2021, 223,882 QBP and 93,675 VXU messages have gone through MiHIN since the beginning of April, specifically for the City of Detroit as a result of this project. All of the messages that are part of our ONC program with the City of Detroit end up in the statewide dashboard (hosted and analytics performed by the State of Michigan) in addition to payer, hospital, health department, and others immunization data.
Project Title: Leveraging Oklahoma's Health Information Ecosystem to Advance Public Health.
MyHealth is proposing to continue our work with the Oklahoma State Department of Health (OSDH) and the Oklahoma State Immunization Information System (OSIIS) to improve interoperability in our state. MyHealth will partner with OSIIS to build a bi-directional interface on behalf of our members to facilitate immunization submission as well as the integration of immunization information into the HIE. In addition, MyHealth will receive and process COVID-19 Vaccine information in order to support clinical and population health efforts by leveraging that data together with the other clinical, claims, and social determinants data available in the HIE. This work will help to improve not only tracking and reporting on the deployment of the vaccine and boosters throughout the Oklahoma population with special focus given to high-risk patients but will also aid in identifying critical gaps in vaccine administration in order to guide public health efforts. OSDH has also requested MyHealth’s help with COVID-19 reporting around breakthrough cases and hospitalizations. The work that MyHealth proposes to do through this project will improve Health IT capabilities and data sharing between HIEs, State agencies, Immunization Information Systems, and healthcare providers to improve the health and healthcare of Oklahomans.
Project Title: Community HIE role in public health response to COVID-19.
RGV HIE is a non-profit organization dedicated to facilitating the secure exchange of patient health information to improve communication and patient care in deep South Texas. The RGV HIE brings a regional-level infrastructure solution that connects information between participating health care organizations and providers by integrating disparate systems and enabling the exchange and use of critical patient information for making care related decisions at the point of care.
As a grant recipient, RGV HIE seeks to become the aggregate source of health data to support our local public health agencies’ abilities to advance data-driven prevention of, response to, and recovery from public health events, including disasters and pandemics such as COVID-19. Funding from the STAR HIE Program will specifically be used to strengthen the existing HIE infrastructure by connecting with our State Health Information system and to implement a Clinical Data Warehouse to facilitate research, bio surveillance and knowledge generation around the epidemiology of diseases like COVID-19.
Our partnerships will expand HIE services to include a clinical research framework addressing the COVID-19 crisis and enabling interoperability to address future Public Health crises. Our goals for the STAR HIE Program include: Improving the information structure to share patient data with the public health department; increasing the data quality of the records being used to perform contact tracing, surveillance, and research; and better identifying the sources of a disease and help prevent additional outbreaks.
Project Title: Situational Awareness for Novel Epidemic Response: How Health Information Exchange can Strengthen Readiness of Public Health via HL7 FHIR.
The Texas Health Services Authority, in partnership with HASA, a regional HIE covering multiple regions in Texas, a local hospital partner, and Audacious Inquiry, will conduct a proof-of-concept pilot to demonstrate real-time, automated exchange of hospital capacity and other situational awareness data through APIs using HL7® Fast Healthcare Interoperability Resources (FHIR®). This information will be co-located with state immunization data in a capacity tracking dashboard, allowing state and local public health officials to understand where there may be gaps in vaccination distribution and low hospital capacity. This improved functionality will not only simplify hospitals' public health reporting but will also support the Texas Department of State Health Services, local health departments, emergency management agencies, and health care organizations across the state.
Project Title: Strengthening the Technical Advancement and Readiness of Public Health via Health Information Exchange.
The Health Collaborative will work with seventeen (17) regional counties, using claims data aggregation to run risk score measures to assist with identifying the targeted populations that require COVID-19 vaccination. In coordination with the Ohio Department of Health, we propose synchronizing and augmenting the state’s vaccination registry with our HIE data. The benefit to public health is two-fold: Vaccination information will present through our longitudinal patient record and will further arm the state’s system with valuable statistics to be utilized by public health for tracking and trending.
Goals:
1) Provide a listing of high-risk people in the state of Ohio who have not yet been vaccinated and 2) Compare certain health conditions in those who have been vaccinated to those who have not and track at least one health condition of the two population cohorts/report any discrepancies.
Project Title: Connect Health Data to Support Public Health Emergency Response Activities.
This project will support COVID-19 vaccination data needs for public health in the State of Rhode Island, including the sharing of data with the Rhode Island regional Immunization Information System, the Rhode Island Child and Adult Immunization Registry (RICAIR). This project will leverage the experience and expertise of RIQI, which includes supporting the myriad public health information needs during the COVID-19 pandemic.
The project will leverage data made available from connection between RIQI and RICAIR to support population-level decision applications such as for: (1) Identifying individuals in high-risk populations who have not yet received COVID-19 vaccination and (2) Developing population-based approaches to monitor individuals for adverse events and potential long-term health effects of the vaccine. In supporting COVID-19 vaccinations needs for an entire state, through a collaboration with a statewide health information exchange and department of health, this project will establish essential infrastructure that may be used for subsequent vaccination event monitoring. It is anticipated that this project will demonstrate the potential for a full learning health cycle, where vaccination rate and adverse event information will be used to guide public health decision making.
Project Title: Data Insights into Public Health Emergencies Through a Common Analytic Platform - West Virginia Health Information Network Providing Data to West Virginia’s Bureau of Public Health.
WVHIN serves as the sole state-designated Health Information Exchange for West Virginia. Through the STAR HIE Program, WVHIN incorporates incoming COVID-19 vaccination data from federal and state sources to ensure the West Virginia SIIS database is complete and current. WVHIN will use its Master Patient Index (MPI) to reduce the volume of unknown race data in COVID-19 lab test results and COVID-19 vaccinations to help state policymakers to pinpoint outbreaks in communities of color and understand gaps in vaccination rates among all communities.
WVHIN will deploy ImmuTrack, an application which will allow providers to view their entire patient panel and the vaccination status of those patients in one document; providers can download and sort the panel by vaccination status to optimize outreach to patients who require a second dose, booster dose or are vaccine hesitant. Prior to ImmuTrack implementation, providers had to query WVSIIS on a patient-by-patient basis. Post-pandemic, WVHIN will seek to expand ImmuTrack use beyond COVID-19 vaccines. Lastly, WVHIN will construct vaccination heat maps so policymakers can understand where the gaps are in vaccination status on a geographic basis.
RESOURCES
- Notice of Funding Opportunity – STAR HIE ProgramSept 2020