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Electronic Health Records

Description

Under the CDC STD Surveillance Network (SSuN) Part B grant, WA DOH is testing electronic case reporting (eCR) of sexually transmitted infections (STI) from a clinical partner.

Objective

We reviewed CCDs (a type of consolidated clinical data architecture (C-CDA) document) shared by our clinical partner, Planned Parenthood of the Great Northwest and Hawaiian Islands (PPGNHI) since October, 2015. Analyses focuses on:

-Completeness

-Degree to which the CCD matches program area information needs

-Differences in EHR generation methods

-Presence and location of triggers (based on the Reportable Conditions Trigger Codes) that would initiate CCD generation.

Submitted by teresa.hamby@d… on
Description

Nearly all of the myriad activities (or use cases) in clinical and public health (e.g., patient care, surveillance, community health assessment, policy) involve generating, collecting, storing, analyzing, or sharing data about individual patients or populations. Effective clinical and public health practice in the twenty-first century requires access to data from an increasing array of information systems, including but not limited to electronic health records. However, the quality of data in electronic health record systems can be poor or “unfit for use.” Therefore measuring and monitoring data quality is an essential activity for clinical and public health professionals as well as researchers. 

Objective

To extend an open source platform for measuring the quality of electronic health data by adding functions useful for syndromic surveillance 

Submitted by Magou on
Description

CRE are drug-resistant bacteria that have a mortality rate of up to 50% in those infected. Several clusters of CRE have been detected in Illinois, often in long-term acute care hospitals. In response, Illinois created the XDRO registry, a mandatory reporting system designed to aid inter-facility communication concerning CRE.

Despite being a high priority for control in the US, the case definition for CRE has been the subject of debate3. There are over 70 Enterobacteriaceae which can have different mechanisms of carbapenem resistance. Criteria for carbapenem resistance include susceptibility results and phenotypic or genotypic detection. The case definition for the XDRO registry is intentionally more exclusive (specific) than that used by CSTE (Table 1). CSTE utilizes a definition designed to maximize sensitivity. Illinois’ XDRO registry’s definition is more specific, meant to reduce unnecessary adoption of contact precautions and the negative consequences some patients may experience.

Currently, case reporting to the XDRO registry is a manual data entry process, which has important advantages. However, transitioning to automatic ELR integration will streamline the reporting process and minimize data entry effort. Unfortunately, the clinical information needed to investigate XDROs is often not captured by ELR. The eCR is a new message type being piloted in Illinois that contains many clinical data elements. We examined the feasibility of combining ELR and eCR into reports for the XDRO registry. In the construction of these reports, we examined the impact of using CRE definitions from CSTE and the XDRO registry. 

Objective

To streamline carbapenem-resistant enterobacteriaceae (CRE) surveillance by integrating electronic laboratory reporting (ELR) data and electronic case reports (eCR) automatically into Illinois’ extensively drug-resistant organism (XDRO) registry. 

Submitted by Magou on

In this webinar Dr. Travers will review two tools developed at the University of North Carolina at Chapel Hill, which aid in processing textual CC’s and triage notes in support of syndromic surveillance. Textual data from emergency departments (EDs) is a common source of data for syndromic surveillance. In the last few years the adoption of electronic health records systems in EDs has improved the availability of timely electronic data from EDs for secondary uses however using these data for syndrome surveillance can still be problematic.

Description

EMRs are a potentially valuable source of information about a patient’s history of health risk behaviors, such as excessive alcohol consumption or smoking. This information is often found in the unstructured (i.e., free) text of physician notes. It may be difficult to classify and analyze health risk behaviors because there are no standardized formats for this type of information1. As well, the completeness of the data may vary across clinics and physicians. The application of automated classification tools for this type of information could be useful for describing patterns within the population and developing disease risk prediction models.

Natural Language Processing (NLP) tools are currently used to process EMR free text in an automated and systematic way. However, these tools have primarily been applied to classify information about the presence or absence of disease diagnoses. The application of NLP tools to health risk behaviors, particularly alcohol use information from primary care EMRs, has thus far received limited attention. 

Objective

The research objective was to develop and validate an automated system to extract and classify patient alcohol use based on unstructured (i.e., free) text in primary care electronic medical records (EMRs).

Submitted by Magou on
Description

The Minnesota Department of Health (MDH) needs to be able to collect, use, and share clinical, individual-level health data electronically in secure and standardized ways in order to optimize surveillance capabilities, support public health goals, and ensure proper follow-up and action to public health threats. MDH programs, public health departments, and health care providers across the state are facing increasing demands to receive and submit electronic health data through approaches that are secure, coordinated, and efficient; use appropriate data standards; meet state and federal privacy laws; and align with best practices. This framework builds upon existing informatics models and two past studies assessing health information exchange (HIE) conducted by the MDH Office of Health Information Technology (OHIT) to provide MDH surveillance systems with an outline of the key elements and considerations for transitioning to more secure, standards-based, electronic data exchange. 

Objective

To create an informatics framework and provide guidance to help Minnesota’s public health surveillance systems achieve interoperability and transition to standards-based electronic information exchange with external health care providers using the state’s birth defects registry as an initial pilot program. 

Link to publication: 

View the abstract here

 

Submitted by uysz on
Description

RTI International has worked on enhancing health information and disease surveillance systems in many countries, including The Democratic Republic of the Congo (DRC), Guinea, Indonesia, Kenya, Nepal, Philippines, Tanzania, Zambia, and Zimbabwe. Strengthening these systems is critical for all three of the Prevent, Detect and Respond domains within the Global Health Security Agenda. 

We have deep experience in this area, ranging from implementing District Health Information Software (DHIS), electronic medical records, health facility registries, eHealth national strategies, electronic Integrated Disease Surveillance and Response system (eIDSR), mobile real-time malaria surveillance and response, national weekly disease surveillance, patient referral system, and community based surveillance. These experiences and lessons learned can inform work being done to advance the GHSA.

We will discuss several examples, including activities in Zimbabwe and Tanzania. RTI has been working in Zimbabwe for over six years to strengthen the national health information system. This work has included the configuration and roll-out of DHIS 2, the national electronic health information system. In doing so, RTI examined and revitalized the weekly disease surveillance system, improving disease reporting timeliness and completeness from 40% to 90%. Additionally, RTI has integrated mobile technology to help more rapidly communicate laboratory test results, a laboratory information management systems to manage and guide test sample processing, and various other patient level systems in support of health service delivery at the local level. This work has involved capacity building within the ministry of health to allow for sustainable support of health information systems practices and technology and improvements to data dissemination and use practices. 

Objective

The objective is to discuss two decades of international experience in health information and disease surveillance systems strengthening and synthesize lessons learned as applicable to implementation of the Global Health Security Agenda (GHSA). 

Submitted by uysz on

More and more patients frequent Urgent Care facilites. In this webinar, we will discuss how NSSP jurisdictions collect it, how is it formatted, and what have they learned; what's the best way to capture and share this information; and why should we collect and report this data.

Presenters

David Swenson, AHEDD Project Manager, New Hampshire Department of Health and Human Services, Division of Public Health Services, Communicable Disease Surveillance Section

Join ISDS on June 3rd for an instructional webinar on ICD-9-CM and ICD-10-CM/PCS mapping tools, including the newly released MapIt tool. This tool, which was developed by AHRQ and CDC, is an automated mapping tool that utilizes General Equivalence Mappings (GEMs) to provide both forward and backward or reverse mapping between ICD-9-CM and ICD-10-CM codes.