The following article is available:
Electronic Health Records can be used to strengthen public health and primary care collaboration.
Answer these questions after you have read this article:
Discuss how informatics can be used in public health to support surveillance and management for communicable and chronic diseases.
Reviewed Article: Enhancing Primary Care Collaboration and Public Health through Electronic Health Records
Authors: Neil Calman MD, Diane Hauser MPA, Joseph Lurio MD, Winfred Yu.Wu MD, MPH, and Michelle Pichardo MPH.
Electronic Health Records (EHRs), which can be used to improve coordination between primary care providers and public departments for insurance and maintenance of health in the population, can be useful.
This system can be used to document the health information of patients, improve surveillance of chronic and communicable diseases, and provide critical alerts regarding public health goals and objectives. It works in real-time with diagnosis and treatment (Varonen Korteisto & Kaila 2008).
How can electronic health records improve surveillance and management of communicable and chronic diseases?
The selected journal’s authors point out that EHR can improve monitoring and supervision of chronic and communicable disease.
Syndromic surveillance allows for monitoring symptoms that could indicate a communicable disease or infection (Overview Syndromic Surveillance: What is Syndromic?, 2017).
EHR can assist in this by automatically reporting data to the relevant department of health (Birkhead Klompas & Shah 2015).
EHR can send routinely collected symptoms and demographic information to the concerned department of health. This can be used to create a map showing common symptoms associated with different locations.
This will help you to identify any outbreak patterns.
The system can generate alerts that act as reminders to providers during the diagnosis of reportable diseases. It also provides a link to the reporting form (Schiff and al., 2017).
The system automatically populates demographic information, which reduces the provider’s workload.
The system automatically uploads immunization and lead screening data to the server, eliminating the need for manual uploads.
These data can be used by providers to check immunization history for patients and prevent duplication or gaps in immunization schedules (Shankar, et al. 2016).
Health Alert Networks, which are used by almost all public health agencies, can distribute findings from epidemiological investigations.
An alert is sent to local providers only if there is a rise in the number of disease-related cases.
These alerts can be used to prompt healthcare providers to take action and treat those suspected of developing these conditions.
EHRs can be used to ensure that healthcare providers are actively involved in monitoring diseases.
Patients can have their specimens collected by providers. This can then be used for research and surveillance (Gale, et al. 2017, 2017).
EHR can be used to monitor and manage Chronic Diseases. It also allows for the implementation of public health agendas that prioritize care for those diseases that have a significant impact on public health (Perlman, et al. 2017).
The system can incorporate the alerts based upon the guidelines and facilitate compliance, using disease registers and reports.
The alerts can be used to prompt providers to notify patients who are due for screening, tests or visits.
Providers can also use the alerts to send appropriate referrals to patients for further treatment and checkup.
EHR data can be used to identify risk groups for certain chronic conditions or diseases. This can increase early detection and encourage preventative behavior.
This data can be combined with demographic information to screen for specific diseases in immigrants from countries where there is high incidence.
This information can be exchanged between the public health, primary healthcare centres, individuals, and the population to improve surveillance and management.
New York City Health Promotion and Disease Prevention Practices
The New York City Department of Health and Mental Hygiene, (NYC DOHMH), developed and tested the HER system. It is used to monitor potentially fatal conditions such as tuberculosis.
NYC DOHMH implemented Health Alert Network public health alerts for West Nile Virus diseases, prompting healthcare providers to consider this disease when treating patients with headaches and fevers (Asnis et. al. 2000; Calman et. al. 2012).
The data on the proportion of patients who reported influenza-like symptoms during the H1N1 outbreak helped to identify peak months of infection and redistribute immunization funds accordingly.
Figure 1: Percentage patient visits to New York City sites for influenza like illness (ILI), Institute for Family Health, June 8,-December 4, 2009. Source: (Calman and al., 2012).
Figure 2: Percentage patient visits to New York State’s Mid Hudson Valley sites for influenza-like disease (ILI): Institute for Family Health. Source: Calman et. al., 2012.
NYC DOHMH monitors diseases and medical conditions (like Tuberculosis) by using registers and reporting on the notifiable illnesses (like West Nile Virus).
NYC DOHMHMH launched the Take Care New York initiative (TCNY) in 2004 for chronic diseases.
The initiative identified 10 goals to improve health in New York.
These goals include regular doctor visits, avoiding tobacco, maintaining a healthy heart, being aware of your HIV status, getting help with depression, not using drugs or alcohol, getting immunized, preventing cancer and keeping the home safe and sound.
EHR alerts are created keeping these goals in mind and can raise a warning if they are compromised.
These alerts can also be used to educate patients.
These alerts can be used to track the incidence of the disease, which can aid in better managing it.
Flushing hospital’s experience with the West Nile virus epidemic in New York, 1999.
Clinical Infectious Diseases 30(3), 413-418.
Electronic health records are used to improve public health surveillance.
Annual review of public Health, 36, 345-359.
Electronic Health Records can strengthen public health and primary care collaboration.
American Journal Of Public Health, 11(11), e13-18.
360 Specimen Collection after Implementation of the New Electronic Health Record: Work as Imagined Versus Work As Performed.
Annals of Emergency Medicine 70(4), S142.
Syndromic Surveillance Overview What is Syndromic surveillance?
Innovative Population Health Surveillance: The use of electronic health records for chronic disease surveillance.
American Journal of Public Health,107(6), 853-857.
Journal of the American Medical Informatics Association 24(2), 281-287.
Access to online immunization records in real time and their impact on tetanus coverage in the ED.
Cognitive Computing and Information Processing, 2016 Second International Conference (pp.
A focus group study with doctors to determine what may help or hinder the adoption of computerized decision-support systems (CDSSs).