Existing electronic medical billing record (EMBR) systems in patient care facilities may be useful for public health surveillance. We compared an existing EMBR system, in the emergency department and acute care clinics of Grady Memorial Hospital in Atlanta, Georgia, with an Olympic Sentinel Surveillance (OSS) system specifically devised to monitor adverse health events of public health interest during the 1996 Summer Olympic Games in Atlanta. While there was substantial overall agreement between the two systems, certain categories, such as injuries, differed considerably. Reasons for such disagreement included clerical errors, varying levels of coder expertise, subjective differences in coding of diagnoses, and the fact that the two systems were designed for different purposes. Automated processing of existing computerized medical records can be useful for public health surveillance, and is cheaper than special-purpose surveillance which is based on manual data abstracting. Causation, risk factors, and severity of illness are not reflected directly in standard ICD codes. "E" codes to indicate causation, though available on the Grady EMBR forms to record a secondary diagnosis, were rarely utilized. Therefore, it seems that "E"-coding for causation requires stronger motivation than was present in this setting.
Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to: 1. Appreciate that data of value in public health surveillance currently resides in existing electronic medical billing records systems used by hospitals and other patient care facilities. 2. Understand the difficulties involved in utilizing such data for surveillance purposes. 3. Identify ways to modify the ICD-9-CM coding of hospital visits in order to facilitate improved public health surveillance.
Keywords: Surveillance, ICD
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Grady Memorial Hospital, Atlanta, Georgia
Division of Public Health, Georgia Department of Health and Human Resources, Atlanta, Georgia
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.