Download PDF
Appl Clin Inform 2025; 16(02): 234-244
DOI: 10.1055/a-2441-6100
Research Article

Initial Real-World Pilot of the MedMorph Reference Architecture: Hepatitis C Surveillance and Research

Maria Michaels
1   Centers for Disease Control and Prevention, Office of Public Health Data, Surveillance, and Technology, Atlanta, Georgia, United States
,
Nathan E. Botts
2   Westat, Inc., Rockville, Maryland, United States
,
Susan Hassell
2   Westat, Inc., Rockville, Maryland, United States
,
Russell Mardon
2   Westat, Inc., Rockville, Maryland, United States
,
Eric Chung Ren Pan
2   Westat, Inc., Rockville, Maryland, United States
,
Mike Flanigan
3   Carradora Health, Inc., Rockville, Maryland, United States
,
Chirine Chehab
1   Centers for Disease Control and Prevention, Office of Public Health Data, Surveillance, and Technology, Atlanta, Georgia, United States
,
Sara Liu
4   MDLand International Corporation, New York City, New York, United States
,
Angelica Bocour
5   New York City Department of Health and Mental Hygiene, New York City, New York, United States
,
Mark Alexander
5   New York City Department of Health and Mental Hygiene, New York City, New York, United States
,
Angel Aponte
5   New York City Department of Health and Mental Hygiene, New York City, New York, United States
,
Nicola D. Thompson
6   Centers for Disease Control and Prevention, Atlanta, Georgia, United States
› Author Affiliations Funding The majority of this work was supported by the Office of the Secretary for Health and Human Services Patient-Centered Outcomes Research Trust Fund under Interagency Agreement (IAA) #750119PE090047 (from Assistant Secretary for Planning and Evaluation [ASPE] to CDC). The funding from this IAA was used to fund: IAA # AHRQ 20-624R-20 (from CDC to AHRQ), which then funded: AHRQ Contract # 75Q80120D00023, Task Order #75Q80121F32001 (from AHRQ to Westat, Inc.), which also included compensation in the form of an honorarium to MDLand to support technical development required for the pilot. GSA contract #47QTCA19D0013, Order #75D30120F07077 (from CDC to Carradora Health, Inc.). A portion of the work [for NYC DOHMH] was supported by NU50CK000517-04-00, NU50CK000517-01-09, and 6 NU50CK000517-02-04 of Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (RFA CK19-1904).
› Further Information
Also available at
    Permissions and Reprints

Abstract

Objectives This study aimed to demonstrate real-world use of the Making Electronic Data More Available for Research and Public Health (MedMorph) Reference Architecture (RA) for automated exchange of hepatitis C-related data for public health surveillance and research using Fast Healthcare Interoperability Resources (FHIR).

Methods Pilot participants included a public health authority (PHA), research organization (RO), clinical sites, and electronic health record (EHR) vendors. The RA was tested for hepatitis C public health surveillance and research data exchange. A mixed methods evaluation used multiple data sources to assess impact of the RA compared with usual methods.

Results After implementation of the RA components, there was no burden on clinical staff to report data for public health surveillance or research purposes. Data were successfully transferred and passed from EHR to PHA and RO, which revealed the value of receiving clinical data in addition to laboratory data via electronic laboratory reporting for the PHA and limitations in the Bulk FHIR standard.

Conclusion Initial results indicate potential for long-term reduction of level of effort of reporting while improving the availability and completeness of clinical data for public health surveillance and research. Using a FHIR-based approach that aligns with regulatory health information technology certification requirements and existing infrastructure may reduce implementation burden. The MedMorph approach can enhance public health surveillance and research, resulting in improved data completeness and reduced reporting burden through automated data exchange using industry standards. MedMorph will continue to inform Centers for Disease Control and Prevention's Public Health Data Strategy, which provides the agency's direction for data modernization.

Keywords

implementation and deployment - FHIR - public health - infectious disease - clinical research informatics - testing and evaluation - facilitators and barriers - monitoring and surveillance - EHRs and systems - data processing

Protection of Human and Animal Subjects

Review by the Westat IRB covered evaluation activities, including the qualitative interview plan and plan for management and analysis of deidentified aggregate quantitative data. The IRB determined the evaluation was exempt from further review.


Authors' Contributions

All authors listed have contributed to this article as follows:


• Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND


• Drafting the work or reviewing it critically for important intellectual content; AND


• Final approval of the version to be published; AND


• Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.


Data Availability

The data underlying this article are available in the article.


Note

The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of U.S. Centers for Disease Control and Prevention.




Publication History

Received: 11 July 2024

Accepted: 14 October 2024

Article published online:
12 March 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany