Public Health Meaningful Use

Three of the 10 Stage One Meaningful Use menu set requirements specify electronic transmission of the following data to Public Health:

• Immunizations, 
• Laboratory results for reportable conditions, and 
• Syndromic Surveillance.

Eligible Providers/Hospitals must meet five of the menu set requirements, one of which must be a public health requirement. The measure for validation of Stage One public health meaningful use requires only that a single test be performed, and if successful, that transmission should continue if public health is ready to continue receipt. It is not necessary for the test to succeed in order to meet the Stage One PH MU requirement measure.

The Division of Public Health's (DPH) current interpretation of the final rule puts the burden of electronic health record (EHR) technology certification on the Eligible Providers/Hospitals and their system vendor(s). Accordingly, the DPH does not need to validate if the sending EHR system or component is certified, nor do the public health systems that receive the data need to be certified, only capable of accepting data per the applicable standards and implementation specifications.

The final rule and standards are silent on the transmission method, other than it must be electronic. The DPH interprets this to mean that existing transmission-level mechanisms such as the use of Public Health Information Network Messaging System (PHIN-MS) may be used. The public health systems will continue to accept transmissions in a variety of methods, i.e., batch, real-time, etc., but at the discretion of the DPH.

The DPH and its agents are capable of accepting electronic transmissions for all three Public Health Meaningful Use requirements but may, due to resource or scheduling constraints at any given time, be unable to accept test submissions and continue receipt of submissions if the test is successful for one or more requirements.

If the DPH or its agents are unable to accept test submissions, a letter indicating this lack of capacity will be provided by the DPH. You may request the letter by sending your request via email to Denise.Webb@dhs.wisconsin.gov. In this situation, the DPH recommends your organization follow the attestation instructions and guidance from the Centers for Medicare and Medicaid Services (CMS) for claiming an exclusion to the appropriate data submission meaningful use menu set measure. Information on the Electronic Health Records (EHR) Incentive Program can be found at: http://www.cms.gov/ehrincentiveprograms/ 

Contact information for CMS Region 5 is provided below should you have any questions about the attestation requirements:

Additional detail on each of the public health requirements can be found below.

Immunizations

The Wisconsin Immunization Registry (WIR) can receive submissions of immunization data from eligible hospitals and eligible providers in either HL7 2.3.1 or HL7 2.5.1 format. Further details can be found on the Wisconsin Immunization Registry website.

Syndromic Surveillance

The Office of the National Coordinator (ONC) has not finalized the standards and guidelines for syndromic surveillance. The original standards, released in July 2010, were withdrawn and the International Society for Disease Surveillance (ISDS), with support from the Centers for Disease Control and Prevention's BioSense Program, was tasked with leading the development of new standards and guidelines.

ISDS released the results of this effort as the "Final Recommendation: Core Processes and EHR Requirements for Public Health Syndromic Surveillance." (exit DHS) Following the release of the Final Recommendation, CDC published the "PHIN Messaging Guide for Syndromic Surveillance: Emergency Department and Urgent Care Data" (exit DHS; PDF, 1.4 MB) and a related "PHIN Messaging Guide Syndromic Surveillance: Emergency Department and Urgent Care Data - Release 1.0 Questions and Answers"  (exit DHS; PDF, 127 KB)

The DPH recommends that eligible providers and eligible hospitals interested in meeting the public health syndromic surveillance Meaningful Use objective proceed using the ISDS Final Recommendation and the PHIN Messaging Guide for guidance.  

Please Note -- The following scope statement is taken from the PHIN Messaging Guide:

"The ISDS Final Recommendation 3, Section 1.2.1 defines the … most important data sources for syndromic surveillance: emergency department (ED) and urgent care (UC) patient visits captured by health information system and sent to a public health authority. These data sources are in scope of the ISDS Recommendations and provide the foundation for the PHIN Messaging Guide for Syndromic Surveillance: Emergency Department and Urgent Care Data. In the future, ISDS will extend the scope of data sources including ambulatory providers for syndromic surveillance and a subsequent PHIN Messaging Guide for Syndromic Surveillance: Ambulatory Data will be published."

The Wisconsin Division of Public Health is presently not capable of accepting syndromic surveillance data from new data submitters and will not have the capacity to support new interfaces in 2012.  A letter indicating this lack of capacity will be provided by the DPH. (See above for detail.)

The primary contact at the DPH for syndromic surveillance reporting for the purpose of meeting the meaningful use requirement is Denise Webb. She can be reached by phone at (608) 267-6767 or email: Denise.Webb@dhs.wisconsin.gov. 

Electronic Laboratory Reporting

Electronic laboratory reporting of reportable conditions to the Wisconsin Electronic Disease Surveillance System (WEDSS), a web-based application used by state and local public health staff for communicable disease surveillance and case management, is managed for the DPH by the Wisconsin State Laboratory of Hygiene (WSLH).

The WSLH accepts lab reports in a variety of formats, translating and transforming them as necessary for transmission to WEDSS. WSLH has the capability to receive submissions for testing and continued submission if the test is successful. Due to resource or scheduling constraints at any given time, the WSLH may be unable to accept test data. A letter indicating this lack of capacity will be provided by the DPH. (See above for detail.)

The primary contact for electronic laboratory reporting for the purpose of meeting the meaningful use requirement at the DPH is Denise Webb. She may be reached by phone at (608) 267-6767 or via email addressed to Denise.Webb@dhs.wisconsin.gov. 

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Last Revised: May 18, 2012