although two syndromic surveil- lance systems do operate within the state: Tarrant County Public Health’s syndromic surveillance system and the surveillance system of the now- defunct Texas Association of Local Health Officials (TAHLO). The Hous- ton Health Department now admin- isters the TAHLO system. The Texas Cancer Registry can help physicians attest to meaningful use objective 10. DSHS is working with local health departments across Texas and other partners to develop and implement a new, modern syndromic surveillance system that can serve to help identify emerging health threats and inform local decision-making while protect- ing individuals’ privacy,” the depart- ment states on its Syndromic Surveil- lance webpage. Dr. Gilmer says CMS hasn’t defined
key terms such as “public health agen- cy” and “jurisdiction” for the purposes of objective 10. “How do I know whether I’m in
the category of providers, and what is the jurisdiction?” he said. “Is it Harris County, is it my school district, is it the State of Texas, is it the United States, or is it the World Health Organiza- tion? What’s their jurisdiction? I have a problem understanding what they’re trying to get me to do.” CMS was unable to grant an inter- view to Texas Medicine by press time.
REGISTRY RUSH The third measure in objective 10, al- lowing physicians to establish active engagement with a specialized reg- istry, isn’t available to every specialty. An April 2015 study in the Journal for Healthcare Quality found that among the American Medical Association’s 117 specialty societies, only 16.2 per- cent were affiliated with a registry. (See “Specialty Registries Are Rare,” opposite page.) For specialty societies that do have
one, there’s no guarantee of success- ful implementation, as San Antonio rheumatologist Chelsea Clinton, MD, discovered. Dr. Clinton, chair of the
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