Advancing Public Health Data Exchange: KONZA’s Success with the STAR HIE Program

ASTP launched the Strengthening the Technical Advancement and Readiness of Public Health via Health Information Exchange (STAR HIE Program) in 2020. In 2021, it was expanded to increase support for efforts to improve vaccination data sharing between state and local immunization information systems (IIS) and HIEs. KONZA in Topeka, Kansas was among the 22 recipients that received a combined $5 million in funds from ASTP via the CARES Act.

We sat down with the KONZA National Network team, one of the initial awardees, to learn how the STAR HIE Program helped support the state's public health agency exchange health information during the COVID-19 pandemic. (Answers have been edited for clarity.)

ASTP: How did KONZA use STAR HIE Program funding?

KONZA: We accomplished several things with the STAR HIE Program funding. In partnership with the Kansas Department of Health and the Environment (KDHE), we developed a COVID-19 Registry and a de-identified population health dashboard (HQ Insights) that presented COVID-19 results and immunization rates. This allowed KONZA to increase race/ethnicity data completeness (see chart).

KONZA developed and deployed TRANSLATE, a new electronic process to report physician COVID-19 lab results to state public health registries by converting existing HIE lab messages to compliant public health lab messages. This removed the manual reporting burden for physician practices and public health registries and replaced it with a low cost, electronic solution using existing HIE data feeds.

KONZA also funded a full-time public health project manager to support integration activities, provide technical support for capturing the provider's Clinical Laboratory Improvement Amendments (CLIA) and Logical Observation Identifier Names and Codes (LOINC) information, and support enrollment with public health agency (PHA) electronic laboratory reporting (ELR), immunization registry, and syndromic surveillance systems.

ASTP: What problems or challenges did you encounter, and how did the STAR HIE Program funding help?

KONZA: We deployed TRANSLATE in Kansas, Missouri, Mississippi, Connecticut, and Texas, but each state's public health agency required slightly different data formats for reporting COVID-19 results. This required custom data mapping for each state. The STAR HIE Program funding supported efforts to base TRANSLATE on the Mississippi standard for data formatting which captured the greatest number of fields. Then we could tailor the data mapping for the other states by removing or customizing the Health Level Seven International® (HL7®) message to comply with individual PHA requirements.

The STAR HIE Program provided the funding necessary for providers to implement HL7 interfaces for public health, eliminating additional financial burden on the provider.

ASTP: How will you build on this work and what are some future projects for KONZA?

KONZA: We continue to support providers connecting to multiple state registries, including those focused on immunizations, ELR, syndromic surveillance, cancer, and birth defects. KONZA has been designated as a Qualified Health Information Network (QHIN™) to facilitate the exchange of health data on a nationwide scale. QHINs will allow providers, patients and payers secure, seamless access to complete patient health records regardless of location. In addition, where providers are ready to implement electronic case reporting, we are providing project management support to enable submission to the Association of Public Health Laboratories Informatics Messaging Services Platform.

The KDHE Health Acquired Infection/Antimicrobial Resistance program investigates infections caused by multi-drug resistant organisms (MDRO), bacteria that have become resistant to certain antibiotics. KONZA is partnering with KDHE to extend the use of our existing KHIN-Rapid Alerts Direct to send MDRO alerts to facilities, triggering the need for isolating patients on admission into their facility. The pilot program includes one specific type of MDRO, Carbapenem-Resistant and Extensively Drug-Resistant Acinetobacter baumannii. The pilot program will run for 12 months across five hospitals and five post-acute care facilities. Based on the outcome of the pilot, KDHE may expand the MDRO project to additional facilities and may renew for an additional three years.

ASTP: How has the STAR HIE Program positioned you to better respond to public health emergencies?

KONZA: The STAR HIE Program allowed us to establish trusting relationships and strengthened communication with PHAs. Working together through the COVID-19 response has increased the overall awareness of our capabilities and demonstrated how we may support PHAs to quickly respond with timely, high-quality data that directly informs decision making.

The STAR HIE Program provided KONZA with further exposure to some of the challenges faced by state agencies such as workforce, siloed infrastructure, and barriers to data modernization.

Working closely with the PHAs also provided insight to shared strengths and weakness. The program has created opportunities to prepare for future public health emergencies as we now continue to meet regularly with our PHA partners. This regular communication is critical to maintaining situational awareness of emerging health care and public health challenges that will require a comprehensive and coordinated response.

ASTP: How do you plan to stay engaged with your public health partners?

KONZA: KONZA will continue to incorporate state public health agencies' promoting interoperability and data modernization objectives into its strategic and operational plans. KONZA staff represent HIEs on multiple public health workgroups alongside our PHA partners. These workgroups develop strategies for advancing capabilities of the existing HIEs to achieve public health priorities.

ASTP: Why was this program necessary during the COVID-19 response?

KONZA: We were able to rapidly develop the KDHE COVID-19 Registry, making critical information available to care providers and public health agencies at both the state and local level. TRANSLATE rapidly captured data from physicians and clinics that otherwise would have required slower, manual reporting. By the end of the program, KONZA delivered more than 500,000 data points to PHAs. That availability of timely and high-quality data was necessary to support informed decision making and response during the pandemic.

The program was also necessary for us to recognize the need to adapt and adopt capabilities quickly to contribute to public health response. We learned the language of public health, which included its distinct definitions and syntax, and we further enhanced our data capabilities to integrate to PHAs. This program expanded our existing portfolio of public health solutions and provided an opportunity to demonstrate the value of HIE and PHA partnerships.

Learn more about KONZA. Learn more about ASTP's STAR HIE Program.

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