How disease surveillance systems can serve as practical building blocks for a health information infrastructure: the Indiana experience.

Although many organizations are beginning to develop strategies to implement and study regional and national health information exchanges, there are few operational examples to date. The Indiana Network for Patient Care (INPC) is an example of a currently operational Regional Health Information Organization (RHIO) built upon a foundation of open, robust healthcare information standards. Having demonstrated the scalability of this design, the Indiana State Department of Health (ISDH) contracted with the Regenstrief Institute to implement a statewide disease surveillance system incorporating encounter data from all 114 Indiana hospitals with emergency departments. We describe the 4-year implementation plan, including our design rationale and how we plan to address the specific implementation challenges of data collection, connectivity in diverse environments and current hospital buy-in. To date, 36 hospitals are in various stages of engagement, with 19 hospitals actively providing real-time surveillance data. We will discuss how this project creates the foundation for a potential statewide health information exchange.