Developing Phenotypes from Electronic Health Records for Chronic Disease Surveillance

Chronic diseases, including hypertension, type 2 diabetes mellitus (diabetes), obesity, and hyperlipidemia, are some of the leading causes of morbidity and mortality in the United States. Monitoring disease prevalence guides public health programs and policies that help prevent this burden. EHRs can supplement traditional sources of chronic disease surveillance, such as health surveys and administrative claims datasets, by offering near real-time data, large sample sizes, and a rich source of clinical data.

June 18, 2019

Comparing Cerebral Palsy Surveillance Definition to ICD Codes and Written Diagnoses

Cerebral Palsy (CP) is the most common cause of motor disability in children. CP registries often rely on administrative data such as CP diagnoses or International Classification of Diseases (ICD) codes indicative of CP. However, little is known about the validity of these indicators. We calculated sensitivity, specificity, positive and negative predictive values of CP ICD-9 codes and CP diagnoses compared to a gold standard CP classification based on detailed medical and education record review.

June 18, 2019

ED visits for AMI, Stroke, ACS & COPD after the Statewide Smoking Ban in Cook Co., IL

Tobacco use is the leading global cause of preventable death, killing more than five million people per year. In addition, exposure to secondhand smoke is estimated to kill an additional 600,000 people globally each year. In 1986, the US Surgeon General’s Report declared secondhand smoke to be a cause of lung cancer in healthy nonsmokers. The first law restricting smoking in public places was enacted in 1973 in Arizona that followed the 1972 Surgeon General’s Report providing awareness of the negative health effects associated with the exposure to air pollution from tobacco smoke.

January 21, 2018

Assessment of the use of ED Chief Complaint Data for monitoring Chronic Diseases

Syndromic Surveillance (SS), traditionally applied to infectious diseases, is more recently being adapted to chronic disease prevention. Its usefulness rests on the large number of diverse individuals visiting emergency rooms with the possibility of real-time monitoring of acute health effects, including effects from environmental events and its potential ability to examine more long-term health effects and trends of chronic diseases on a local level.


January 21, 2018

Factors associated with hospitalization due to streptococcal infection in Houston, Texas 2015-2016

Different studies have shown that Streptococcal infections in adults are more common among older age, blacks, and underlying chronic medical conditions like diabetes, cardiovascular and kidney diseases. In specific, other studies have demonstrated that streptococcal pyogenes can cause severe illnesses and dramatic hospital outbreaks. Furthermore, community-acquired pneumonia studies had also suggested that cardiovascular disease, severe renal disease, chronic lung disease and diabetes were associated with increased odds of hospitalization.


January 25, 2018

A Comparison of Clinical Surveillance Systems in New York City

The widespread adoption of Electronic Health Records and the formation of Health Information Exchanges has opened up new possibilities for public health monitoring. Since 2009, The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) has been developing two public health surveillance systems for chronic diseases. The first is the NYC Macroscope, which is built on a distributed query network (the Hub) of 740 New York City ambulatory practices all using proprietary software from one EHR vendor (eClinicalWorks).

August 07, 2017

Addressing Health Equity Through Data Collection and Linked Disease Surveillance

In 2012, half of all adults in the US had one or more chronic health conditions; at least 25% had two or more chronic health conditions. Seven of the top ten causes of death in 2010 were chronic diseases; two of the seven chronic diseases, heart disease and cancer, account almost for over 50% of all deaths. Chronic disease is one of the most costly contributors in healthcare expenditures; once diagnosed many patients must be followed for a lifetime. In lower-income countries chronic disease is now the biggest contributor to mortality.

August 07, 2017

Automated Collection of Electronic Health Record Healthy Weight Data for Surveillance

Clinical data captured in electronic health records (EHR) for patient health care could be used for chronic disease surveillance, helping to inform and prioritize interventions at a state or community level. While there has been significant progress in the collection of clinical information such as immunizations for public health purposes, greater attention could be paid to the collection of data on chronic illness. Obesity is a chronic disease that affects over a third of the US adult population1 , making it an important public health concern.

September 28, 2017

Using Ambulatory Syndromic Surveillance Data for Chronic Disease: A BMI Case Study

Syndromic surveillance is one of the meaningful use public health menu set objectives for eligible professionals. The value of this data for syndromic surveillance as an adjunct to the more widely adopted emergency department registrations has not been studied extensively. It may be that it would improve the sensitivity or timeliness of detecting certain communicable disease events, or it may just contain signals comparable to what is available via other syndromic surveillance data streams.

November 08, 2017

Emergency Department Chief Complaint Versus Discharge Diagnosis for Tracking Disease Measures

ESSENCE is a web-based syndromic surveillance system utilized by DHMH to detect and track outbreaks, suspicious patterns of illness, public health emergencies, and biological threats. ESSENCE ED chief complaint data is collected daily from 47 emergency departments in Maryland (all 45 acute care hospitals and 2 freestanding emergency medical facilities). A chief complaint in ESSENCE is a free text field that lists the patient’s reason for the ED visit upon arrival at the hospital.

August 22, 2018


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