Expanding electronic health information: Implications for public health practice

The expanded use of electronic medical records (EMR) and the development of health information exchanges (HIE) can provide public health with increasing amounts of data. The majority of health data systems such as syndromic and reportable diseases are maintained in silos. In addition, public health agencies are challenged to evaluate and respond to the actionable data findings with decreased resources both IT infrastructure and personnel.

Systems and statistical tools are needed to improve the conversion of data to information that can inform public health response at federal, state, and local levels. Design considerations include efficiency, workforce needs, and cost. Systems should also support the use of other electronic data such as local geographic information.

Challenges in public health surveillance and practice include:

• Differentiating outbreaks from improved reporting related to new diagnostic testing

• Identification of high risk contacts for screening and prophylaxis in health care institutions and other congregate living settings

• Identifying disease transmission patterns and the effectiveness of countermeasures including personal protective equipment and prophylaxis

• Increased case counts with limited resources for individual investigations.

Successful strategies will need to consider data availability and quality, cross jurisdictional communication, and workforce training needs at federal, state and local agencies. Statistical tools, mapping, and informatics have the potential to improve public health surveillance and response. Collaborative partnerships are essential to improve the timeliness, efficiency and effectiveness of public health surveillance.