EHR Toolkit

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EHR Toolkit

• Tools for Public Health E-Surveillance
• Jim Jellison, MPH
• Dave Ross, ScD
• CDC Health Information Innovation Consortium
  (CHIIC),
• Quarterly Forum - August 2015

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Topics

• EHR adoption trends and public health response
• EHR Toolkit resource
• Public health surveillance and the business of
  population health

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EHR Adoption Trends, Hospital and Office-based
Clinical Settings
Sources Charles, D. et al. ONC Data Brief no.
23 (2015) Furukawa, M. et al. Health Affairs
Vol. 33 No. 9 (2014)
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CDC Surveillance Strategy (2014)

• Enhance accountability, resource use, workforce
  and innovation for surveillance
• Accelerate utilization of emerging tools and
  approaches (e.g. EHRs) to improve availability,
  quality, and timeliness of surveillance data
• Cross-cutting agency initiatives to improve
  surveillance by addressing system usability,
  efficiency, and adoption of new technologies
  moving toward an agency shared surveillance data
  platform

Source http//www.cdc.gov/ophss/docs/CDC-Surveill
ance-Strategy-Final.pdf
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Surveillance Approaches
Individual Case Report Aggregated Case Report
Push Individual-Push Model Example Traditional reportable conditions, registry reporting Aggregate-Push Model Example Influenza-Like Illness (ILI) reporting
Pull Individual-Pull Model Example Outbreak investigation Aggregate-Pull Model Example Distributed queries (chronic disease)
Also, consider a Collaborative Model Public
health agencies partner with providers, community
entities to jointly define population health
questions, share analyses, design interventions.
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Electronic Case Reporting (Individual-Push)
Clinical Care
Public Health Agency
Implement Trigger Codes
Author Reporting Criteria
Consume Reporting Criteria
Reporting Criteria
Patient Meets Reporting Criteria
Clinical Decision Support
Build, Send Case Report
Add Case to Surveillance Database
Case Report
need more info?
Structured Data Capture
Form
Provide Electronic Form
Complete, Send Case Investigation Form
Response
http//www.cste.org/group/RCKMS http//www.thephcp
.org/committees/case-reporting
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Distributed Query (Aggregate-Pull)
Public Health Agency
Author Query
Distribute Query
Analyze Results
Epi
Clinical Practice 1
Review, Run Query
Review, Return Results
Clinical Data
security
security
Clinical Practice n
Review, Run Query
Review, Return Results
Clinical Data
security
security
http//esphealth.org Am J Public Health. 2014
Dec104(12)2265-70 http//www.denverhealth.org/fo
r-professionals/clinical-specialties/public-health
/colorado-health-observation-regional-data-service
-chords http//www.nyc.gov/html/doh/html/data/nycm
acroscope.shtml
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phii.org/ehrtoolkit

• On-line tools and resources to help public health
  agencies access and use EHR data
• Adaptable to a wide range of conditions
• Built around comprehensive planning questions,
  sound informatics principles
• Free!

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Surveillance Information Life Cycle
3. Forming Partnerships
2. Clarifying Legal and Policy Issues
Tools Include Logic Model Total Cost of
Ownership Preparing for Attorneys Defining
Roles Responsibilities
1. Making the Value Case
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Surveillance Information Life Cycle
Tools Include Defining Data Elements Understandi
ng Clinical Data Defining System
Requirements Syntactic, Semantic, and Technical
Interoperability Worksheets
5. Analyzing Technical Options
4. Understanding Clinical Data and Workflows
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Surveillance Information Life Cycle
Tools Include Piloting and On-boarding Analysis,
Visualization, and Reporting Evaluation
7. Optimizing Data Quality and Use
6. Implementing Data Exchange
phii.org/ehrtoolkit
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Public health surveillance and the business of
population health

• What information can we expect from EHRs?
• What kind of cooperation can we expect from
  health care providers?
• Whats this I hear about EHR vendors and their
  population health tools?

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Acknowledgements

• Funding from CDC/CSELS Cooperative Award No.
  U38OT000216  
• Brian Lee, CDC Project Officer
• Denver Public Health
• Massachusetts Department of Public Health

Thank you!

• phii.org/ehrtoolkit