Strengthening Public Health and Primary Care Collaboration Through Electronic Health Records

Calman, Neil S.; Hauser, Diane; Lurio, Joseph; Wu, Winfred; Pichardo, Michelle

doi:10.2105/ajph.2012.301000

Cited by 40 publications

(34 citation statements)

References 16 publications

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“…By collecting and sharing data across health care organizations, HIE networks are significantly transforming the work of both clinical and public health, with increased opportunity for more automated and efficient data capture [12]. The expanded adoption of HIEs promises to improve access to data and automate its extraction, making it easier to collect required data through electronic request from a single source.…”

Section: Discussionmentioning

confidence: 99%

Leveraging public health's participation in a Health Information Exchange to improve communicable disease reporting

Painter

Revere

Gibson³

et al. 2017

OJPHI

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BackgroundInfectious diseases can appear and spread rapidly. Timely information about disease patterns and trends allows public health agencies to quickly investigate and efficiently contain those diseases. But disease case reporting to public health has traditionally been paper-based, resulting in somewhat slow, burdensome processes. Fortunately, the expanding use of electronic health records and health information exchanges has created opportunities for more rapid, complete, and easily managed case reporting and investigation. To assess how this new service might impact the efficiency and quality of a public health agency's case investigations, we compared the timeliness of usual case investigation to that of case investigations based on case report forms that were partially pre-populated with electronic data.InterventionBetween September 2013-March 2014, chlamydia disease report forms for certain clinics in Indianapolis were electronically pre-populated with clinical, lab and patient data available through the Indiana Health Information Exchange, then provided to the patientâ€™s doctor. Doctors could then sign the form and deliver it to public health for investigation and population-level disease tracking. Methods: We utilized a novel matched case analysis of timeliness changes in receipt and processing of communicable disease report forms. Each Chlamydia cases reported with the pre-populated form were matched to cases reported in usual ways. We assessed the time from receipt of the case at the public health agency: 1) inclusion of the case into the public health surveillance system and 2) to close to case. A hierarchical random effects model was used to compare mean difference in each outcome between the target cases and the matched cases, with random intercepts for case.ResultsTwenty-one Chlamydia cases were reported to the public health agency using the pre-populated form. Sixteen of these pre-populated form cases were matched to at least one other case, with a mean of 23 matches per case. The mean Reporting Lag for the pre-populated form cases was 2.5 days, which was 2.7 days shorter than the mean Reporting Lag for the matched controls (p = <0.001). The mean time to close a pre-populated form case was 4.7 days, which was 0.2 days shorter than time to close for the matched controls (p = 0.792).ConclusionsUse of pre-populated forms significantly decreased the time it took for the local public health agency to begin documenting and closing chlamydia case investigations. Thoughtful use of electronic health data for case reporting may decrease the per-case workload of public health agencies, and improve the timeliness of information about the pattern and spread of disease.

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Section: Discussionmentioning

confidence: 99%

Leveraging public health's participation in a Health Information Exchange to improve communicable disease reporting

Painter

Revere

Gibson³

et al. 2017

OJPHI

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“…EHR-based data were found to correlate well with hospital ED-based syndromic reporting; the data from structured queries were slightly better correlated. The same data were useful during the 2009 H1N1 influenza pandemic to determine the geographic distribution of influenza cases and to direct public health resources such as vaccines (7). In another study, EHRbased syndromic surveillance using the ESPnet system to detect ILI was highly correlated with traditional sentinel surveillance data (44).…”

Section: Influenza/influenza-like-illness Surveillancementioning

confidence: 92%

Uses of Electronic Health Records for Public Health Surveillance to Advance Public Health

Birkhead

Klompas

Shah

2015

Annu. Rev. Public Health

279

203

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Public health surveillance conducted by health departments in the United States has improved in completeness and timeliness owing to electronic laboratory reporting. However, the collection of detailed clinical information about reported cases, which is necessary to confirm the diagnosis, to understand transmission, or to determine disease-related risk factors, is still heavily dependent on manual processes. The increasing prevalence and functionality of electronic health record (EHR) systems in the United States present important opportunities to advance public health surveillance. EHR data have the potential to further increase the breadth, detail, timeliness, and completeness of public health surveillance and thereby provide better data to guide public health interventions. EHRs also provide a unique opportunity to expand the role and vision of current surveillance efforts and to help bridge the gap between public health practice and clinical medicine.

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“…With EHRs and HIEs in place, public health agendas can include clinical care data and more widely address population level concerns. 43 Interoperability of systems can assist in timely and efficient alerts, emergency response, population research, detailed analysis, refined interventions, future preparations for health, and overall coordination of care for patients. 13,33 HIEs are important community partners; our study results regarding low HIE connectivity may have implications for PHAB standards requiring health departments to collaborate in assessing and assuring provision of essential public health services.…”

Section: Provision Of Computers Andmentioning

confidence: 99%

Overcoming Barriers to Experience Benefits: A Qualitative Analysis of Electronic Health Records and Health Information Exchange Implementation in Local Health Departments

Williams¹,

Shah²,

Leider³

et al. 2017

eGEMs

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Introduction: Electronic Health Records (EHRs) and Health Information Exchanges (HIEs) are changing surveillance and analytic operations within local health departments (LHDs) across the United States. The objective of this study was to analyze the status, benefits, barriers, and ways of overcoming challenges in the implementation of EHRs and HIEs in LHDs. Methods:This study employed a mixed methods approach, first using the 2013 National Profile of LHDs survey to ascertain the status of EHR and HIE implementation across the US, as well as to aid in selection of respondents for the second, interview-based part of project. Next, forty-nine key-informant interviews of local health department staff were conducted. Data were coded thematically and independently by two researchers. Coding was compared and re-coded using the consensus definitions.Results: Twenty-three percent of LHDs nationwide are using EHRs and 14 percent are using HIEs. The most frequently mentioned benefits for implementation were identified as care coordination, retrieval or managing information, and the ability to track outcomes of care. A few mentioned barriers included financial resources, resistance to change, and IT related issues during implementation.Discussion: Despite financial, technical capacity, and operational constraints, leaders interviewed as part of this project were optimistic about the future of EHRs in local health departments. Recent policy changes and accreditation have implications of improving processes to affect populations served. Conclusions:Overcoming the challenges in implementing EHRs can result in increased efficiencies in surveillance and higher quality patient care and tracking. However, significant opportunity cost does exist.

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Strengthening Public Health and Primary Care Collaboration Through Electronic Health Records

Cited by 40 publications

References 16 publications

Leveraging public health's participation in a Health Information Exchange to improve communicable disease reporting

Leveraging public health's participation in a Health Information Exchange to improve communicable disease reporting

Uses of Electronic Health Records for Public Health Surveillance to Advance Public Health

Overcoming Barriers to Experience Benefits: A Qualitative Analysis of Electronic Health Records and Health Information Exchange Implementation in Local Health Departments

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