In the US, healthcare and public health are both in the jurisdiction of the individual states, or so I'm told. When I think about this a little more, it is very interesting to observe that the central government is NOT a committee or conglomerate of state governments. So, technically, the center is supposed to create rules in the appropriate jurisdiction. Wait, it becomes a little more complicated - the center controls a lot of money that is for healthcare purposes (think Medicare), and... money is power.
What does this lead to?
Rules being created by the central government that individual states will extend and change as per their likes, leading to possibly 50 different ways to do the same thing. While I believe in allowing the states to do what it best for them, I think that it would make a lot of sense for the center to invite state representatives to get input as well as buy-in.
A leading example of this is the group of public health menu options for meaningful use. It seems like immunization experts and owners from different states have already solved this in some way by getting together. I welcome comment from all on how we can take the immunization folks' success model and apply it to electronic lab reporting and syndromic surveillance.
I'm not sure you can claim success for Immunizations. There is still a grewt deal of variety across the states
ReplyDeleteYes, you are right. However, immunizations seems a lot further ahead in consistency among states when compared to ELR and Surveillance.
ReplyDelete