Partner Engagement Strategies
Acessing EHI for public health is not just a legal or technical task, it is a relationship-driven process. Identifying the right partners, communicating transparently, and demonstrating shared values lays the foundation for long-term collaboration and improved public health outcomes. Shared interest in addressing the health priorities of the community can form the basis of these relationships.
To successfully establish access to EHI, strong relationships with healthcare organizations (HCOs) are essential. These relationships are built on mutual understanding, trust, and shared goals for improving population health.
This section provides practical guidance for identifying key stakeholders within HCOs and establishing effective, lasting partnerships.
Identifying the Right Partners in the HCO
Public health professionals should proactively identify individuals who hold influence, technical knowledge, and operational authority for collaboration in establishing access to EHI. Begin with a review of the HCO’s website, to identify the specific individuals filling these roles, so you can mention them when making initial contact. If you are working with a Tribal HCO, a proper first step would be to speak with the Tribal government, especially if the HCO is Tribally operated. You should be able to locate a main number or administrative office for this initial contact. Identifying yourself and your role at the public health authority (PHA) should be sufficient for you to be connected directly to the person you have identified.
| Role | Why Engage with Them |
| Chief Medical Officer (CMO)/ Clinical Leadership | Provides valuable insights into hospital operations and clinical practices; interested in improving the quality of care and ensuring the health and well-being of the community |
| Chief Information Officer (CIO)/ Health Information Technology (IT) Director | Oversees health IT systems; key for electronic health record (her) integration and data exchange |
| Health Information Management (HIM) Director | Manages access to patient records and privacy practices |
| Chief Compliance/Privacy Officer | Interprets legal parameters for protected health information (PHI) disclosure under HIPAA and state, Tribal, local and territorial (STLT) law |
| Informatics or Data Exchange Leads | Facilitates technical connections (e.g., application programming and other interfaces, registries) |
| Community Engagement or Population Health Teams | Often act as liaisons between HCOs and PHAs |
Building Trust and Transparency
Building trust and transparency with HCOs is crucial because it fosters accountability, improves decision-making, and enhances engagement, which can ultimately lead to better health outcomes. Below are suggested ways to build trust and transparency:
1. Lead with shared purpose to emphasize the common mission of protecting the health of individuals and communities.
- Consider approaching this from the perspective that public health should be considered part of the care team network, providing a vital function similar to others within the HCO who already have full EHR access
- The care team may already include infection prevention, case management, social work, and nursing
2. Clarify to HCOs what public health surveillance is by describing the role of surveillance in taking public health action. Some high level talking points could include:
- An overview of public health functions and the role of the PHA
- The purpose of public health surveillance and the role of the epidemiologist
- Timeliness of surveillance activities and how EHI fills in gaps and allows for a more complete understanding
- The important role of reportable conditions and reporting requirements in relation to protecting the health of the public
- Invitation for HCOs to become essential partners whose information contributions strengthen public health awareness and activities
- Examples where EHI has been critical in taking public health action:
- Sexually transmitted infections (STI) – a PHA routinely reaches out to HCOs when they see that an inappropriate treatment was provided for syphilis, gonorrhea and other STIs.
- Tuberculosis – a PHA frequently receives questions about tuberculosis and latent tuberculosis infections from HCOs and access to medical records allows them to provide public health expertise and real-time care for patients
- Outbreak investigations – the ability for the PHA to look at patient charts for those involved in outbreaks allows for additional case finding, treatment guidance, and implementation or de-escalation of isolation precautions
3. Be clear about what you’re asking for – HCOs are sometimes wary of vague requests. Be prepared to communicate:
- The specific data needed for PHA surveillance and other activities
- The legal authority for access (e.g., HIPAA’s public health exception)
- The estimated frequency of EHR usage by public health professionals
- Your PHA’s security and privacy safeguards in processing and accessing the data
For examples of initial information requests scripts that can be tailored to your specific needs: Download Scripts For Why Access Is Needed
For an example of how to communicate these item: Download the EHI Access Request Letter
4. Create mutual value – strong relationships are not one-sided. Demonstrate how collaboration helps HCOs:
- Reduce HCO burden through direct EHR access
- Meet public health disease reporting requirements more efficiently
- Contribute to disease prevention and public trust
- Receive data back to inform care and treatment (e.g., regional trends, dashboards, diagnoses, outbreak alerts)
Offer to:
- Close the loop by sharing meaningful analytics or public health alerts
- Provide FAQs for clinical staff
- Maintain a consistent communication cadence (monthly check-ins, update emails) and a regular meeting schedule to foster relationships and maintain open lines of communication
- Connect new HCOs with a champion at other HCOs where you already have established relationships and EHI access
- As appropriate, recognize the HCO publicly for their collaboration
For more information about the value of EHI access for HCOs visit the Benefits and Rationale for Public Health tookit chapter.
5. Be Accessible and Consistent
- Assign a dedicated contact person at your PHA for follow-up
- Respond quickly and professionally to concerns or changes in PHA or HCO leadership, or EHR vendors
Success Story : James Lewis, Snohomish County Health Department
When James Lewis stepped into leadership at the Snohomish County Health Department in August 2022, he recognized that limited access to EHRs was slowing outbreak investigations and disease surveillance. By focusing on relationship-building with healthcare leadership, clearly communicating how shared data benefits patients and providers alike, and navigating legal and technical hurdles one partner at a time, the department expanded direct EHR access from a single hospital to over 80% of health care organizations countywide and growing. This transformation has accelerated workflows, cut case investigation time, and enabled public health staff to act decisively with more complete information in hand. As Lewis put it, “It’s mostly about relationships and getting the right person involved. We’re batting a thousand so far — every organization we’ve asked for, we’ve gotten. It can take time but it’s worth it and widely appreciated by our staff.”
