270576 Secondary Use of a Migrant Farmworker Database: Moving Towards a Learning Healthcare System

Sunday, October 28, 2012

Valerie Mac, RN, BSN , Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA
Introduction: A growing body of evidence suggests that database inaccuracies, incomplete fields and gaps in data collection hinder assessment of secondary clinical data. In order to advance evidence-based practice, we must assess the functionality of database system components, ease of access, and identify limitations to ensure meaningful use of future electronic health information records. Purpose: The objective of this independent study was to assess “meaningful use” of electronic health record data. Methods: Using a Learning Healthcare Systems framework, we examined the Moultrie Databases from the last 10 years to characterize system versus user oriented information retrieval as it pertains to function, storage and collection of electronic health information in service learning settings. Results: User access barriers included formatting of entry fields impeding assessment of blood pressure, vision and hemoglobin ICD-9 diagnostic codes, screening service codes and CPT codes. There are currently no guidelines in place to inform appropriate formatting of the data nor protocols that outline collective use, storage and access measures of an amendable database. Limitations: Due to the nature of the service learning project and the population served, we are unable to track patients from year-to-year for continuity of records. Conclusions: Issues of user access and retrievability of the electronic health information in the Moultrie database must be addressed to improve database functionality as a tool for tracking longitudinal healthcare outcomes. Nursing Research Implications: Development of guidelines related to database formatting, composition and system organization will bolster models for future data collection in community-based, service learning settings.

Learning Areas:
Program planning
Provision of health care to the public
Public health or related nursing
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Define the term "meaningful use" Identify strategies that can be used to assess the degree of "meaningful use" of a database.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral student at Emory University working under the direction of Dr. Linda McCauley who specializes in migrant farmworker health and vulnerable populations. My clinical background is community-based care including public health, women's health, school health and home health care. Among my specific interests are meaningful use of clinical databases and environmental health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.