Multiple options (1,2) are available for health care provider organizations to receive assistance in demonstrating compliance with meaningful use requirements for public health reporting (3). A certified EHR solution is a requirement for participation in these programs; vast majority of health care providers do not yet have such a solution. No funding programs are currently available to assist public health agencies, especially local public health departments (4). As a result, most providers and local public health agencies are seemingly left without viable options except spending significantly in a tight budget environment.
Objective
To describe a real-time reportable disease and surveillance solution focused on local public health department needs and compatible with state health departments, regardless of meaningful use certification status of health care providers.
The use of health information systems to electronically deliver clinical data necessary for notifiable disease surveillance is growing. For health information systems to be effective at improving population surveillance functions, semantic interoperability is necessary. Semantic interoperability is “the ability to import utterances from another computer without prior negotiation” (1). Semantic interoperability is achieved through the use of standardized vocabularies which define orthogonal concepts to represent the utterances emitted by information systems. There are standard, mature, and internationally recognized vocabularies for describing tests and results for notifiable disease reporting through ELR (2). Logical Observation Identifiers Names and Codes (LOINC) identify the specific lab test performed. Systematized Nomenclature of Medicine-Clinical Terms (SNOMED CT) identify the diseases and organisms tested for in a lab test. Many commercial laboratory and hospital information systems claim to support LOINC and SNOMED CT on their company websites and in marketing materials, and systems certified for Meaningful Use are required to support LOINC and SNOMED CT. There is little empirical evidence on the use of semantic interoperability standards in practice.
Objective:
To characterize the use of standardized vocabularies in real-world electronic laboratory reporting (ELR) messages sent to public health agencies for surveillance.
Submitted by
Magou
on
Description
Traditionally Emergency Department syndromic surveillance methods have relied on ICD-9 codes and chief complaints. The implementation of electronic medical record keeping has made much more information available than can potentially be used for surveillance. For example, information such as vital signs, review of systems and physical exam data are being stored discreetly. These data have the potential to detect specific diseases or outbreaks in a community earlier that the traditionally used ICD-9 and chief complaint.
Objective
This paper describes the integration of novel data sets from an Emergency Department Electronic Medical Record into a syndromic surveillance application.