Journal
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION
Volume 21, Issue 1, Pages 132-138Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/amiajnl-2012-001591
Keywords
-
Ask authors/readers for more resources
Objective Increasing use of electronic health records (EHRs) provides new opportunities for public health surveillance. During the 2009 influenza A (H1N1) virus pandemic, we developed a new EHR-based influenza-like illness (ILI) surveillance system designed to be resource sparing, rapidly scalable, and flexible. 4 weeks after the first pandemic case, ILI data from Indian Health Service (IHS) facilities were being analyzed. Materials and methods The system defines ILI as a patient visit containing either an influenza-specific International Classification of Disease, V. 9 (ICD-9) code or one or more of 24 ILI-related ICD-9 codes plus a documented temperature >= 100 degrees F. EHR-based data are uploaded nightly. To validate results, ILI visits identified by the new system were compared to ILI visits found by medical record review, and the new system's results were compared with those of the traditional US ILI Surveillance Network. Results The system monitored ILI activity at an average of 60% of the 269 IHS electronic health databases. EHR-based surveillance detected ILI visits with a sensitivity of 96.4% and a specificity of 97.8% based on chart review (N=2375) of visits at two facilities in September 2009. At the peak of the pandemic (week 41, October 17, 2009), the median time from an ILI visit to data transmission was 6 days, with a mode of 1 day. Discussion EHR-based ILI surveillance was accurate, timely, occurred at the majority of IHS facilities nationwide, and provided useful information for decision makers. EHRs thus offer the opportunity to transform public health surveillance.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available