Recommendations for Syndromic Surveillance Using Inpatient and Ambulatory EHR Data
Published Date:Apr 4 2013
Source:Online J Public Health Inform. 2013; 5(1).
To develop national Stage 2 Meaningful Use (MUse) recommendations for syndromic surveillance using hospital inpatient and ambulatory clinical care electronic health record (EHR) data.
MUse will make EHR data increasingly available for public health surveillance. For Stage 2, the Centers for Medicare & Medicaid Services (CMS) regulations will require hospitals and offer an option for eligible professionals to provide electronic syndromic surveillance data to public health. Together, these data can strengthen public health surveillance capabilities and population health outcomes (Figure 1).
ISDS, in collaboration with the Division of Informatics Solutions and Operations at the Centers for Disease Control and Prevention (CDC), and HLN Consulting, convened a multi-stakeholder Work-group of clinicians, technologists, epidemiologists, and public health officials with expertise in syndromic surveillance. Recommended MUse guidelines were developed by performing an environmental scan of current practice and by using an iterative, expert and community input-driven process. The Workgroup developed initial guidelines and then solicited and received feedback from the stakeholder community via interview, e-mail, and structured surveys. Stakeholder feedback was analyzed using quantitative and qualitative methods and used to revise the recommendations.
The MUse Workgroup defined electronic syndromic surveillance (ESS) characteristics. Specifically, data are characterized by their timeliness, sensitivity rather than specificity, population focus, limited personally identifiable information, and inclusion of all patient encounters within a specific healthcare setting (e.g., emergency department, inpatient, outpatient). Based on stakeholder input (n=125) and Workgroup expertise, the guidelines identify priority syndromic surveillance uses that can assist with: Monitoring population health;Informing public health services; andInforming interventions, health education, and policy by characterizing the burden of chronic disease and health disparities.
The widespread adoption of EHRs, catalyzed by MUse, has the potential to improve population health. By identifying and describing potential ESS uses of new sources of EHR data and associated data elements with the greatest utility for public health, the recommendations set forth by the ISDS MUse Workgroup will serve to facilitate the adoption of MUse policy by both healthcare and public health agencies.
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