Tag Archives: health IT

Public Health – Seattle & King County Implements Certified EHR

CDC/ Debora Cartagena

According to the 2009 Status of Local Health Departments Informatics, over half (55%) of LHDs providing primary care and 39 percent of LHDs providing dentistry services use an electronic, or part electronic, health record. Given the increase in EHR use by LHDs and funding to help EHR users, LHDs are becoming more aware of the importance of electronic health records.

Let’s take a look at Public Health – Seattle & King County and their recent efforts of implementing a certified EHR:

Public Health – Seattle & King County is implementing a new federally certified electronic health record (EHR) integrated with a patient management system through OCHIN/Epic. The new EHR will serve 14 sites, including public health centers, STD/HIV and Tuberculosis clinics, field nursing services, and jail health services.

“Our EHR project is a huge step forward for Public Health’s efforts to advance improvements in individual and public health outcomes while increasing efficiencies,” said Ben Leifer, Chief Administrative Officer for Public Health – Seattle & King County.

Public Health will launch the new EHR system in its primary care clinics beginning in June 2013. The project is expected to be completed by 2015.

“We have been actively planning for the new system since 2009, and our thorough work to date has laid the groundwork for a successful implementation,” said Kristi Korolak, Project Manager.

“OCHIN/Epic will provide us with better tools, in real time, to assess our patients’ needs and improve how we deliver care,” said Dr. Charissa Fotinos, Chief Medical Officer for Public Health. “Further, it will enable better patient coordination with local and regional partners, while supporting broader population-based health promotion and disease control.”

For LHDs who want to learn more information about EHRs, check out these useful resources:

  • HIMSS highlight several tools that can be used to assist in the adoption and implementation of EHR: http://www.himss.org/ASP/topics_ehr.asp
  • The Agency for Healthcare Research and Quality (AHRQ) Knowledge Library includes an implementation checklist to help address potential barriers and challenges to EHR implementation: http://1.usa.gov/cSyYlB
  • The Public Health Data Standards Consortium (PHDSC) Electronic Health Record Public Health Task Force provides information on standards and EHRs: http://www.phdsc.org/health_info/ehr-task-force.asp
  • The Office of the National Coordinator (ONC) for Health Information Technology provides information on the certification programs for EHRs: http://1.usa.gov/bhanF3

For more information on the Public Health – Seattle & King County EHR project, please contact Kristi Koralak.

Many thanks to Kathryn Ross from Public Health – Seattle & King County for contributing to the blog post.


Part 2: How is Health IT Impacting Public Health Case Management?

Installment 2: The ‘state of the art’ of Case Management

When asked, local health departments (LHDs) report overwhelmingly that case management is a service that is universally provided at the local health department level.  Of course there are many types of case management – Women and child health, TB, STD, HIV, Diabetes, Elder Care, Social services, etc.  In each of these examples, there are services that are provided and ‘case managed’ by the health department and there are services that are provided and ‘case managed’ by other entities.  However, care coordination is the key to success.  In this age of electronic health records, new ways of electronic messaging and managing care are cropping up and have the potential to improve efficiency and in return improve outcomes.


Today, case management often starts behind and struggles to catch up to what the client is experiencing.  The client may receive care and be referred to case management or become eligible for case management by diagnosis and the referral can take hours to a month to get to the public health case manager.  It can then take precious time and resources to find the client and encourage them to take advantage of the resources the case manager has to offer – resulting in missed opportunities for help.


However new technologies are coming along to change this picture.  In Olmsted County Minnesota, (part of the MN ONC Beacon Community Project) public health case managers are electronically connecting at the point of care.  So a patient could leave the emergency room and at that moment, the local public health case manager is informed electronically of the visit and given some summary as well.  This electronic connection makes the public health case manager a member of the care team – bringing a community focus to the point of care that has been absent in most communities.  This allows the public health case manager to impact the plan of care and connect the client to community resources when they are needed.

In support of this emerging trend, The Public Health Informatics Institute (PHII) has, with NACCHO’s assistance, partnered with local public health case managers to develop a requirements document for case management.  This document is useful in two ways: 1) It looks across case management types for commonalities and best practices and can be used to improve local case management programs; 2) It can provide a unified view of requirements for vendors to use when building systems that will support and enhance case management.  This document can go a long way to building consensus among local public health case managers about how an electronic case management support system should support their work.  Once there are agreed upon standards and requirements, vendors will have incentive to sell products to this new and growing market.

So what should I do?

NACCHO would love to hear your comments and stories.  How have you utilized technology to support case management?  What successes and/or challenges are you having?  What can we do in order to promote and improve this area of important local public health work?

How is Health IT Impacting Public Health Case Management?

Installment 1: What is Public Health Case Management?

Let’s be clear about what public health case management is.  The Case Management Society of America, a non-profit association dedicated to the support and development of the profession of case management, defines case management as:

“a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality cost effective outcomes.”

How detailed does Public Health Case Management Get?

1)  You must understand that there are different levels of case management – from keeping track of meta-data about a case to involving a case manager in someone’s life.  On the least extreme, case management may simply be tracking that a case received proper treatment according to latest treatment guidelines – never actually interacting with the patient or client.

2)  On the other extreme, the case manager understands patient or client medication schedules, work issues, transportation needs, and other personal issues, while working to get those needs met in order to improve that patient or client’s outcome for the condition or issue under management.

Traditionally this spectrum of case management has been managed with lots of paper –


However, with the health IT revolution underway, there are many new and exciting developments you should be aware of and hopefully taking advantage of.  In our next installment of this 2 part blog post, we’ll delve into the state of the art of Public Health Case Management.