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ONC Data Brief Finds Majority of Hospitals Experience Challenges in Public Health Reporting

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To ensure public health agencies have timely and complete data to improve their disease surveillance capabilities, the Centers for Medicare & Medicaid Services (CMS) established policies that require hospitals to meet specific public health objectives as a condition for participation in the Promoting Interoperability (PI) program. These objectives include submission, and in some cases receipt of data, for the purposes of immunization registries, syndromic surveillance reporting, case reporting, and public health registry reporting.

To understand the challenges hospitals faced with public health reporting in the year prior to the pandemic, the from the Office of the National Coordinator for Health Information Technology (ONC) released a data brief that uses nationally representative survey data from the 2019 American Hospital Association (AHA) Information Technology (IT) supplement to describe the number and types of challenges hospitals experienced when electronically reporting to public health agencies and how these challenges varied by state and hospital characteristics. This analysis identifies potential ongoing barriers to health information exchange among hospitals and public health agencies and provides insights into hospitals’ readiness to support key public health activities prior to the pandemic.


  • In both 2018 and 2019, half of all hospitals reported a lack of capacity to electronically exchange information with public health agencies.
  • In 2019, seven in ten hospitals experienced one or more challenges related to public health reporting.
  • Small, rural, independent, and Critical Access hospitals were more likely to experience a public health reporting challenge compared to their counterparts.
  • The types of public health reporting challenges experienced by hospitals varied substantially at the state-level.

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