EHR Toolkit Tools for Public Health ESurveillance Jim

EHR Toolkit Tools for Public Health ESurveillance Jim Jellison, MPH Dave Ross, Sc. D CDC Health Information Innovation Consortium (CHIIC), Quarterly Forum - August 2015

PHII. org Topics 1. EHR adoption trends and public health response 2. EHR Toolkit resource 3. Public health surveillance and the business of population health

PHII. org 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)

PHII. org 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-Surveillance-Strategy-Final. pdf

PHII. org Surveillance Approaches Individual Case Report Push Individual-Push Model Example: Traditional reportable conditions, registry reporting Pull Individual-Pull Model Example: Outbreak investigation Aggregated Case Report Aggregate-Push Model Example: Influenza-Like Illness (ILI) reporting 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.

Electronic Case Reporting (Individual-Push) Public Health Agency Author Reporting Criteria PHII. org Clinical Care Reporting Criteria Consume Reporting Criteria Implement Trigger Codes Patient Meets Reporting Criteria Add Case to Surveillance Database Case Report need more info? Provide Electronic Form Clinical Decision Support Build, Send Case Report Structured Data Capture Form Response http: //www. cste. org/group/RCKMS http: //www. thephcp. org/committees/case-reporting Complete, Send Case Investigation Form

Distributed Query (Aggregate-Pull) PHII. org Public Health Agency Epi Author Query Distribute Query Analyze Results Clinical Practice #1 security Review, Run Query Clinical Data Review, Return Results security Clinical Practice #n security Review, Run Query Clinical Data http: //esphealth. org Am J Public Health. 2014 Dec; 104(12): 2265 -70 http: //www. denverhealth. org/for-professionals/clinical-specialties/public-health/colorado-health-observation-regional-data-service-chords http: //www. nyc. gov/html/doh/html/data/nycmacroscope. shtml

PHII. org 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!

PHII. org Surveillance Information Life Cycle 3. Forming Partnerships 2. Clarifying Legal and Policy Issues 1. Making the Value Case Tools Include: Logic Model; Total Cost of Ownership; Preparing for Attorneys; Defining Roles & Responsibilities

PHII. org Surveillance Information Life Cycle 5. Analyzing Technical Options 4. Understanding Clinical Data and Workflows Tools Include: Defining Data Elements; Understanding Clinical Data; Defining System Requirements; Syntactic, Semantic, and Technical Interoperability Worksheets

PHII. org 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

PHII. org 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? • What’s this I hear about EHR vendors and their population health tools?

PHII. org Acknowledgements • Funding from CDC/CSELS Cooperative Award No. U 38 OT 000216 • Brian Lee, CDC Project Officer • Denver Public Health • Massachusetts Department of Public Health Thank you! phii. org/ehrtoolkit