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Electronic Health Record Use in Public Health Infectious Disease Surveillance, USA, 2018–2019

  • Technology and Infectious Disease (C Hebert, Section Editor)
  • Published:
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Abstract

Purpose of Review

Electronic health records (EHRs) are an excellent source of data for disease symptoms, laboratory results, and medical treatments. Thus, EHR data may improve the completeness of notifiable disease case reporting and enable longitudinal collection of disease data. The purpose of this review is to examine the current state of EHR use in public health infectious disease surveillance in the USA.

Recent Findings

A wide variety of EHR data is used in infectious disease surveillance. EHR data were used to assess the incidence of Lyme disease and identify newly diagnosed HIV infections. EHR disease detection algorithms combined laboratory reports, diagnosis codes, and medication orders to identify cases and, in the case of Lyme disease, found incidence rates 4–7 times higher than those from traditional surveillance. EHR data were also used to evaluate temporal trends in sexually transmitted disease testing, positivity, and re-testing in several primary care settings. Multiple studies were also able to control for additional confounders in multivariable models, such as number of sexual partners and concurrent infections, because of the breadth of data available in EHR systems.

Summary

Studies highlighted in this review demonstrate that EHR data enhance provider-based and laboratory-based disease reports and may facilitate more complete case reporting. EHR data also provides corollary patient information that enables longitudinal disease reporting and analysis of important health outcomes. As public health infrastructure and investment allow health departments to establish closer relationships with healthcare providers, EHR data use in public health surveillance activities should continue to increase.

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Papers of particular interest, published recently, have been highlighted as: •• Of importance

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Author information

Authors and Affiliations

  1. Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, 02215, USA

    Sarah J. Willis, Noelle M. Cocoros, Aileen M. Ochoa & Michael Klompas

  2. Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, MA, USA

    Liisa M. Randall, Gillian Haney, Katherine K. Hsu & Alfred DeMaria Jr

  3. Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Michael Klompas

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  1. Sarah J. Willis
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  5. Gillian Haney
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Correspondence to Sarah J. Willis.

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Conflict of Interest

Sarah J. Willis, Noelle M. Cocoros, Liisa M. Randall, Aileen M. Ochoa, Gillian Haney, Katherine K. Hsu, Alfred DeMaria, Jr., and Michael Klompas declare that they have no conflicts of interest.

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Willis, S.J., Cocoros, N.M., Randall, L.M. et al. Electronic Health Record Use in Public Health Infectious Disease Surveillance, USA, 2018–2019. Curr Infect Dis Rep 21, 32 (2019). https://doi.org/10.1007/s11908-019-0694-5

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