Electronic Health Records Can Help Strengthen Public Health Response to Disease Outbreaks
By Claire Loe, PhD, MPH, Senior Informatics Analyst
Public Health Informatics Institute, The Task Force for Global Health
The key to effective public health response is capturing timely, accurate and complete data. Quality data inform public health efforts across the spectrum of prevention: from interventions to protect individuals, to community awareness and policy development.
With the broad adoption in recent years of electronic health records (EHRs), public health has the opportunity to take advantage of the availability of electronic health data to improve surveillance. Currently, most clinical care providers use manual mechanisms such as facsimile, web form, email or mailed paper forms to report cases of reportable and notifiable diseases and conditions to public health authorities. Manual reports create a burden on both the clinical provider and public health, and increase the potential for data errors.
Much of the data needed for the case report exists in the patient’s electronic medical record. Automating the building and sending of case reports with EHR technologies holds the promise of reducing the burden of reporting, while improving the timeliness, accuracy and completeness of the data. In turn, better data means better public health action. Such automated reporting is known as electronic case reporting (ECR).
Sexually transmitted infections (STIs) account for most of the reportable condition case reports received by state and local public health agencies and about 85 percent of all notifiable condition reports to the Centers for Disease Control (CDC) each year. In fact, in 2014, over 1.8 million cases of Chlamydia trachomatis and Neisseria gonorrhoeae infections were reported to CDC (CDC, 2015), and they remain a major public health challenge in the United States. When compared to the notifiable disease with the next greatest number of reported cases—salmonellosis with 50,634, (CDC, 2015)—it is clear that automating STI reporting warrants particular attention.
Over the past year, the Public Health Informatics Institute, a program of The Task Force for Global Health, worked with the CDC Division of STD Prevention to provide support to public health agencies and their clinical partners for initiating electronic case reporting of chlamydia and gonorrhea. We convened a panel of experts to reach consensus on data elements to include in case reports, and the case detection logic that triggers a report to be sent from the health care system to the local public health agency. We are also currently working on technical guidance to guide implementation. In the next few weeks, we will release these documents to public health agencies and hope to pilot the work in the next year.
Improving the timeliness and accuracy of this data will allow public health to identify outbreaks more quickly, address disparities in which a disease affects one population more than others, and help ensure that communities are protected.