Electronic Health Records and US Public Health: Current Realities and Future Promise

Friedman, Daniel J.; Parrish, R. Gibson; Ross, David A.

doi:10.2105/ajph.2013.301220

Cited by 76 publications

(45 citation statements)

References 35 publications

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“…Information on clinical diagnoses and outcomes derived from electronic health records (EHRs) is of increasing relevance for both clinicians and researchers [1]. These records represent a rich source of clinical information, collected at minimal cost, in large numbers of people and with potential for linkage to other data sources [2].…”

Section: Introductionmentioning

confidence: 99%

Use of electronic health records to ascertain, validate and phenotype acute myocardial infarction: A systematic review and recommendations

Rubbo

Fitzpatrick

Denaxas

et al. 2015

International Journal of Cardiology

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Electronic health records (EHRs) offer the opportunity to ascertain clinical outcomes at large scale and low cost, thus facilitating cohort studies, quality of care research and clinical trials. For acute myocardial infarction (AMI) the extent to which different EHR sources are accessible and accurate remains uncertain. Using MEDLINE and EMBASE we identified thirty three studies, reporting a total of 128658 patients, published between January 2000 and July 2014 that permitted assessment of the validity of AMI diagnosis drawn from EHR sources against a reference such as manual chart review. In contrast to clinical practice, only one study used EHR-derived markers of myocardial necrosis to identify possible AMI cases, none used electrocardiogram findings and one used symptoms in the form of free text combined with coded diagnosis. The remaining studies relied mostly on coded diagnosis. Thirty one studies reported positive predictive value (PPV)≥ 70% between AMI diagnosis from both secondary care and primary care EHRs and the reference. Among fifteen studies reporting EHR-derived AMI phenotypes, three cross-referenced ST-segment elevation AMI diagnosis (PPV range 71-100%), two non-ST-segment elevation AMI (PPV 91.0, 92.1%), three non-fatal AMI (PPV range 82-92.2%) and six fatal AMI (PPV range 64-91.7%). Clinical coding of EHR-derived AMI diagnosis in primary care and secondary care was found to be accurate in different clinical settings and for different phenotypes. However, markers of myocardial necrosis, ECG and symptoms, the cornerstones of a clinical diagnosis, are underutilised and remain a challenge to retrieve from EHRs.

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Section: Introductionmentioning

confidence: 99%

Use of electronic health records to ascertain, validate and phenotype acute myocardial infarction: A systematic review and recommendations

Rubbo

Fitzpatrick

Denaxas

et al. 2015

International Journal of Cardiology

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“…With ongoing efforts to implement the use of electronic health records in clinical practice increasing, the Tracking Network may be able to capitalize on these efforts to enhance environmental health surveillance. 87,88 Efforts to provide more spatially and temporally refined data measures on environmental hazards, exposures, and health outcomes may help to better answer questions regarding health-environment linkages. In summary, the Tracking Program has made huge strides by developing an infrastructure for making health, exposure, and environmental hazards data available and increasing capacity for understanding associations of diseases of environmental cause.…”

Section: Resultsmentioning

confidence: 99%

A Decade of Environmental Public Health Tracking (2002-2012)

Kearney

Namulanda

Qualters

et al. 2015

Journal of Public Health Management and Practice

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Background The creation of the Centers for Disease Control and Prevention Environmental Public Health Tracking Program spawned an invigorating and challenging approach toward implementing the nation’s first population-based, environmental disease tracking surveillance system. More than 10 years have passed since its creation and an abundance of peer-reviewed articles have been published spanning a broad variety of public health topics related primarily to the goal of reducing diseases of environmental origin. Objective To evaluate peer-reviewed literature related to Environmental Public Health Tracking during 2002-2012, recognize major milestones and challenges, and offer recommendations. Design A narrative overview was conducted using titles and abstracts of peer-reviewed articles, key word searches, and science-based search engine databases. Main Outcomes Eighty published articles related to “health tracking” were identified and categorized according to 4 crossed-central themes. The Science and Research theme accounted for the majority of published articles, followed by Policy and Practice, Collaborations Among Health and Environmental Programs, and Network Development. Conclusions Overall, progress was reported in the areas of data linkage, data sharing, surveillance methods, and network development. Ongoing challenges included formulating better ways to establish the connections between health and the environment, such as using biomonitoring, public water systems, and private well water data. Recommendations for future efforts include use of data to inform policy and practice and use of electronic health records data for environmental health surveillance.

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“…73 The increasingly widespread adoption of EHRs holds great promise for population health surveillance strategies. Data extracted from integrated EHR networks offer the potential for rapid ascertainment of the health status of populations in care, for targeting interventions to vulnerable populations, and for monitoring the impact of such initiatives over time.…”

Section: Discussionmentioning

confidence: 99%

The State of Population Health Surveillance Using Electronic Health Records: A Narrative Review

Paul

Greene

Newton-Dame

et al. 2015

Population Health Management

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Electronic health records (EHRs) are transforming the practice of clinical medicine, but the extent to which they are being harnessed to advance public health goals remains uncertain. Data extracted from integrated EHR networks offer the potential for almost real-time determination of the health status of populations in care, for targeting interventions to vulnerable populations, and for monitoring the impact of such initiatives over time. This is especially true in ambulatory care settings, which are uniquely suited for monitoring population health indicators including risk factors and disease management indicators associated with chronic diseases. As efforts gather steam to integrate health data across delivery systems, large networks of electronic patient information are increasingly emerging. Few of the national population health surveillance systems that rely on EHR data have progressed beyond laying groundwork to launch and maintain EHR-based surveillance, but a limited number of more focused or local efforts have demonstrated innovation in population health surveillance. Common challenges include incompleteness of population coverage, lack of interoperability across data systems, and variable data quality. This review defines progress, opportunities, and challenges in using EHR data for population health surveillance.

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Electronic Health Records and US Public Health: Current Realities and Future Promise

Cited by 76 publications

References 35 publications

Use of electronic health records to ascertain, validate and phenotype acute myocardial infarction: A systematic review and recommendations

Use of electronic health records to ascertain, validate and phenotype acute myocardial infarction: A systematic review and recommendations

A Decade of Environmental Public Health Tracking (2002-2012)

The State of Population Health Surveillance Using Electronic Health Records: A Narrative Review

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