Online Program

Electronic health record surveillance systems: A new approach to chronic disease surveillance

Sunday, November 3, 2013

Katharine McVeigh, PhD, MPH, Division of Family and Child Health, New York City Department of Health and Mental Hygiene, Long Island City, NY
Remle Newton-Dame, MPH, Primary Care Information Project, NYC Department of Health and Mental Hygiene, Queens, NY
Claudia Chernov, MPH, Fund for Public Health in New York, Queens, NY
Sharon Perlman, MPH, Division of Epidemiology, New York City Health Department, Queens, NY
Elisabeth Snell, MPH, Division of Epidemiology, New York City Department of Health and Mental Hygiene, Queens, NY
Jesse Singer, DO, New York City Department of Health and Mental Hygiene, Primary Care Information Project, Long Island City, NY
Lorna Thorpe, PhD, Epidemiology and Biostatistics Program, CUNY School of Public Health at Hunter College, New York, NY
Carolyn Greene, MD, Division of Epidemiology, New York City Department of Health and Mental Hygiene, Queens, NY
Background: Chronic diseases are leading causes of morbidity and mortality worldwide. Traditional methods of chronic disease surveillance are often costly, implemented infrequently, and are rarely designed to provide local data. New surveillance systems based on data from office-based electronic health records (EHRs) have the potential to significantly increase knowledge of the prevalence and management of chronic conditions at the community level, and are becoming more feasible as EHR use becomes widespread. We seek to contribute to the field of electronic health record surveillance system (EHRSS) development by describing the challenges and design decisions encountered during the development of the NYC Macroscope EHRSS. Methods: We reviewed the gray and published literature in this rapidly developing field; spoke with key informants from government, industry, and academia; and developed the indicators, procedures, analytic methods and evaluation criteria for the New York City Macroscope EHRSS. In July 2013 we published a 26-page report documenting lessons learned from these planning activities. Results: EHRSS development requires coordinated leadership and alignment of goals, attention to confidentiality, and technological readiness. Methodological considerations include: system design and interoperability among EHR systems; data quality and standardization of data elements; record selection and indicator definitions; and, data reliability, validity, and generalizability. Discussion: EHRSSs have the potential to provide community level data on chronic disease prevalence and management, but EHRSS development is in its infancy. Our findings contribute to the EHRSS knowledge base and can be used to inform the development of EHRSSs in other jurisdictions.

Learning Areas:

Chronic disease management and prevention
Clinical medicine applied in public health
Communication and informatics
Public health or related research

Learning Objectives:
Describe how electronic health record surveillance systems (EHRSSs) have the potential to revolutionize chronic disease surveillance. Describe the current state of EHRSS development. Discuss the key governance and methodological issues that must be considered when developing an EHRSS. Identify resources to help promote EHRSS development in other communities.

Keyword(s): Surveillance, Health Information Systems

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: N/A

Qualified on the content I am responsible for because: I am the lead epidemiologist working to develop the NYC Macroscope EHRSS and the author of a 26 page report on our experience in this planning phase. I have a master's in public health and doctorate in psychometrics, and have spent the past 10 years analyzing surveillance data from NYC.
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.