Skip to main content

Urgent Care

Description

A comprehensive electronic medical record (EMR) represents a rich source of information that can be harnessed for epidemic surveillance. At this time, however, we do not know how EMR-based data elements should be combined to improve the performance of surveillance systems. In a manual EMR review of over 15 000 outpatient encounters, we observed that two-thirds of the cases with an acute respiratory infection (ARI) were seen in the emergency room or other urgent care areas, but that these areas received only 15% of total outpatient visits. Because of this seemingly favorable signal-to-noise ratio, we hypothesized that an ARI surveillance system that focused on urgent visits would outperform one that monitored all outpatient visits.

 

Submitted by teresa.hamby@d… on
Description

A comprehensive electronic medical record (EMR) represents a rich source of information that can be harnessed for epidemic surveillance. At this time, however, we do not know how EMR-based data elements should be combined to improve the performance of surveillance systems. In a manual EMR review of over 15 000 outpatient encounters, we observed that two-thirds of the cases with an acute respiratory infection (ARI) were seen in the emergency room or other urgent care areas, but that these areas received only 15% of total outpatient visits. Because of this seemingly favorable signal-to-noise ratio, we hypothesized that an ARI surveillance system that focused on urgent visits would outperform one that monitored all outpatient visits.

Submitted by hparton on
Description

In November 2006, Ohioans supported a statute that set into law a requirement that all public places, and places of employment in Ohio prohibit smoking.1 The law took effect in December 2006; however, the rules for implementation were not finalized until June 2007. The primary purpose of the law was to protect employees in all workplaces from exposure to environmental tobacco smoke. When determining how best to evaluate the health impact of a smoke-free law as it relates to secondhand smoke exposure, most studies have reviewed the incidence of heart attacks or AMIs. In the 2006 Surgeon General’s Report, ‘The Health Consequences of Involuntary Exposure to Tobacco Smoke,’2 secondhand smoke exposure is causally associated with cardiovascular events, including AMI. The Institute of Medicine also released a report in 2009 from a meta-analysis, ‘Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence,’3 of 11 epidemiologic studies, reviewing the incidence of acute coronary events following the passing of a smoke-free law. Each of the 11 studies showed a decrease in heart attack rates after implementation of smoke-free laws. The purpose of this study was to evaluate this relationship in Ohio.

Objective

The objective of this study, after completion of the preliminary analysis, was to evaluate whether or not the smoke-free law in Ohio has made a positive change in reducing the effects of secondhand smoke exposure by comparing syndromic surveillance data (trends for emergency department, and urgent care chief complaint visits), related to heart attack and/or acute myocardial infarction (AMI) before and after the smoking ban.

 

Submitted by Magou on
Description

Syndromic surveillance of health care data such as the International Classification of Diseases, Ninth Revision (ICD-9), codes related to Influenza-Like-Illness (ILI), was used to track the progression of the 2009 Fall Novel H1N1 Outbreak in the Madison area. Early studies focused on prediction of an outbreak, however further investigation of patient resource utilization would be helpful in developing an action plan for addressing community and patient needs during future outbreaks. There is a paucity of research comparing emergency department (ED) and urgent care utilization rates during the 2009 Novel H1N1 Pandemic, though there is regional data suggesting that urgent care centers bore a larger portion of the burden of H1N1 influenza than emergency departments. Furthermore, one group found that ILI related phone calls to urgent care centers predicted influenza outbreak at least one week ahead of peaks in the ILI hospital care consultation rates. ED data on its own has proven useful for public health disease surveillance and many studies group urgent care and ED care together. The literature is lacking subgroup analysis of these two very different care environments. Understanding the correlation between urgent care and ED utilization rates will provide a more in depth understanding of the stress that the 2009 Fall Novel H1N1 placed on community resources in our geographic region.

 

Objective

To compare the proportion of patients presenting with ILI to urgent care centers versus the ED during the 2009 Fall Novel H1N1 Outbreak.

Submitted by elamb on

The Urgent Care Sub-Committee(UC) mission is to gather information about urgent care data surveillance and to provide urgent care onboarding support to jurisdictions performing syndromic surveillance. We encourage you to stay connected with this sub-committee.  Urgent Care Sub-Committee updates will be included in the Data Quality Committee monthly meetings. The Urgent Care Forum was developed for you to ask your onboarding questions and to reach out for assistance in Urgent Care onboarding.

Submitted by elamb on
Description

NC DETECT is the Web-based early event detection and timely public health surveillance system in the North Carolina Public Health Information Network. The reporting system also provides broader public health surveillance reports for emergency department visits related to hurricanes, injuries, asthma,  vaccine-preventable diseases, environmental health and others. NC DETECT receives data on at least a daily basis from four data sources: emergency departments, the statewide poison center, the statewide EMS data collection system, a regional wildlife center and laboratory data from the NC State College of Veterinary Medicine. Data from select urgent care centers are in pilot testing.

 

Objective

Managers of the NC DETECT surveillance system wanted to augment standard tabular Web-based access with a Web-based spatial-temporal interface to allow users to see spatial and temporal characteristics of the surveillance data. Users need to see spatial and temporal patterns in the data to help make decisions about events that require further investigation. The innovative solution using Adobe Flash and Web services to integrate the mapping component with the backend database will be described in this paper.

Submitted by elamb on
Description

The Utah Department of Health documented a single epidemic of cryptosporidiosis in Utah during 2007. Seven hundred eleven laboratory-confirmed cases were reported in Salt Lake County, Utah from July 27 through December 18. Illness onset date was available for 86% (611 of 711) of patients and ranged from May 30 through November 11. Approximately 32% (224 of 691) of patients sought care in area emergency departments or urgent care facilities, and 8.5% (50 of 590 with data available) of patients required hospitalization. Sixty-one percent (432 of 711) of patients were less than 13 years of age. Of 381 patients with data available on symptoms, nearly all (99%, 378) reported diarrhea. Other commonly reported symptoms included vomiting (57%, 218), abdominal pain (51%, 196), and nausea (44%, 168).

 

Objective

The objective of this study was to evaluate the potential for improved detection of enteric disease epidemics using a classification category based on variations of diarrhea appearing in the chief complaints from emergency department and urgent care facility visits.

Submitted by elamb on
Description

Norovirus infection results in considerable morbidity in the United States where an estimated 21 million illnesses, 70,000 hospitalizations, and 800 deaths are caused by NV annually. Additionally, NV is responsible for approximately 50% of foodborne outbreaks. Between January 2008 and June 2012, 875 NV outbreaks were reported to the Virginia Department of Health (VDH). To assist in detecting possible disease outbreaks such as NV, VDH utilizes the web-based Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE) to monitor and detect public health events across Virginia. ESSENCE performs automated parsing of chief complaint text into 10 syndrome categories, including a non-specific GI syndrome that serves as a proxy for GI illnesses like NV.

 

Objective

To assess the relationship between emergency department and urgent care center chief complaint data for gastrointestinal illness and reported norovirus (NV) outbreaks to develop an early warning tool for NV outbreak activity. The tool will provide an indicator of increasing NV outbreak activity in the community allowing for earlier public health action to mitigate NV outbreaks.

Submitted by hparton on
Description

While UC does not have a standard definition, it can generally be described as the delivery of ambulatory medical care outside of a hospital emergency department (ED) on a walk-in basis, without a scheduled appointment, available at extended hours, and providing an array of services comparable to typical primary care offices. UC facilities represent a growing sector of the United States healthcare industry, doubling in size between 2008 and 2011. The Urgent Care Association of America (UCAOA) estimates that UC facilities had 160 million patient encounters in 2013. This compares to 130.4 million patient encounters in EDs in 2013, as reported by the National Hospital Ambulatory Medical Care Survey. Public Health (PH) is actively working to broaden syndromic surveillance to include urgent care data as more individuals use these services. PH needs justification when reaching out to healthcare partners to get buy-in for collecting and reporting UC data.

Objective:

Provide justification for the collection and reporting of urgent care (UC) data for public health syndromic surveillance.

Submitted by elamb on