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PHASE II Task 3 Deliverable Directory. The BOH will design business rules to ensure data confidentiality to permit selectively authorized, read-only access to data housed in selected program area modules (PAMs) based on specific user’s roles and responsibilities. The data will be accessible to specific commercial software (e.g., standards-based statistical packages, GIS packages) to support related data analysis and visualization activities, and to support the electronic exchange of laboratory, clinical, and epidemiological data between the state, and other providers and laboratories (dependent on licensing agreements). The currently proposed e-business plan addresses the important and previously unavailable attribute of these disparate data systems that will allow web browser-based development of clinical and public health management reports for improving case management. Selective, confidential, data reporting, querying and messaging functions will be available for authorized users to extend the use of NEDSS data, linked to demographic and disease data, to provide integrated reports of patient demographics, laboratory results, and disease history. E-business would involve periodic reports and case reports available from BOH, or through the query feature for user-generated, ad hoc clinical and management reports. Reports will be available for local stakeholders, with aggregate reports for data comparisons, and individual case reports available for specific data laboratory providers (to safeguard issues of patient confidentiality) as well as state and local public health agencies. Out-of-state laboratories would need to access specific data through the CDC. The capability to query and generate these resultant reports offers value-added identification, communication and program response to directly address public health issues of changes in disease incidence, severity, treatment, and prevention. Local public health agencies and laboratories can be alerted electronically about specific disease states, rates, and data monitoring and reporting requirements to improve detection and treatment management. In addition to these clinical processes and outcomes, the query and reporting functions allow government and clinical laboratories to access aggregated state-wide data that was unavailable previously or available only in hard copy reports by county. These data may be used to enhance financial projections of provider business costs and/or public health program costs, to compare and contrast competitive patterns and projections, and to improve quality assurance through management control and management decision-making that affects patients, communities, public health agencies, and commercial providers alike. III. Costs and Benefits E-business costs are anticipated to be negligible. The initial development of NEDSS has already contemplated the system architecture, design, linkages, and maintenance requirements for the query and reporting functions. The various user communities will need computer equipment and maintenance for access to the web browser, but most if not all components should already exist to meet the previously mandated data entry requirements for reporting the relevant laboratory tests to the BOH data repository. The user communities may need some minor computer software training to effectively utilize the software capabilities to query and produce reports, but these costs should be very low. And, it is anticipated that instructions on how to access NEDDS will be available on-line. Conversely, the benefits of NEDDS from an e-business perspective are significant. In addition to PHRG 2 of 5 September 28, 2001
PHASE II Task 3 Deliverable on-line data entry, query and reporting capabilities of their own data, already noted elsewhere, agencies and providers alike will have newly developed electronic access to broad-based, statewide data, with which they are able to selectively query to ascertain statewide or specific provider trends, patterns, and outcomes. Authorized users will have access to their own provider-specific data as warranted, as well as to statewide aggregated data that has not existed previously. In a manner similar to the current IMMPACT program that tracks immunizations statewide, these query and reporting functions through NEDSS can significantly improve pubic health functions in the state by reducing time, quality, and communication delays in developing and sharing critical public health community alerts and directives. These e-business functions will allow public health agencies to more closely monitor, report, and manage disease-specific prevalence and incidence rates, plus prevention and treatment programs. These e-business functions can improve quality assurance through early detection of trends, improved agency-field communication, best practices analyses, and cost-effectiveness analyses of clinical providers, clinical treatment modalities, and patient and community outcomes. Additionally, the reporting and querying functions of NEDDS will permit physicians, researchers, students and the public health community access to reports that are not now accessible or that require staff time to complete with special runs of the data. This has significant benefit both to the BOH as well as the public sector. Since the NEDSS base system integrated data repository will be structured to permit incorporation of many different additional BOH databases, the e-business benefits of NEDSS will be enhanced multi-fold. For example, the contemplated addition of online collection and reporting of vital statistics data should reduce data collection costs and increase access to data that are routinely used by public health agencies, planners, policy makers, researchers and students. Providing access to these data through NEDDS will highlight the role of BOH and market its importance in the state. Should the BOH require modest fees for these reports, a method of generating revenues to help support the system is realized. IV. Constraints and Risks The e-business functions pose few constraints and risks. Access to the e-business query and reporting functions will follow the previously developed programs, policies, procedures, and restrictions of the Maine Bureau of Health in addressing technology, security, data access, and maintenance issues for NEDSS. The largest concern would encompass issues of data confidentiality and security, principally to effectively ensure that only authorized users are to access NEDSS data, and further to also ensure that authorized users access, report, and transmit the data responsibly, with no disclosure or other inappropriate use of patient or provider data. While the system is purposely “user-friendly,” providers are restricted to accessing either the data they provided on their own patients, or data that are aggregated and cleaned of all patient- or provider-designations. Policies will need to be developed to delineate approved and unapproved access, transmittal, and use of the information developed through the query and reporting functions of NEDSS. A second possible constraint with using these e-business functions involves developing accurate projections for short-term and long-term use of the query and reporting functions through NEDSS. As these e-business functions become more widely publicized, there could be an increase in the number of users employing these functions, especially with the planned expansion PHRG 3 of 5 September 28, 2001
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