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What is the clinical case for these objectives/measures of this priority?

Electronic collection and submission of data to governmental public health agencies allows these bodies to more accurately and efficiently identify underserved populations, gaps in care, and program areas that need to be developed in order to successfully implement quality health measures, increase preventative health screenings and promote medical research. Certified EHRs should be able to provide easily accessible electronic data to support public health initiatives, which is expected to lead to improved health and quality of life in communities across the nation. In addition, public health data can measure the delivery of preventive care and provide disease surveillance. The collection of public health data also allows for public health agencies to provide feedback to providers on disease outbreaks, effective treatments, and other important information that will help clinicians to improve the quality of care provided to patients.  Public health databases can be queried for the number of infectious diseases in a specific hospital or large geographical region.  Syndromic surveillance data can also be combined into regional or national registries for research purposes.  

Providers and hospitals submit this information regularly to state and local public health agencies.  These agencies use this information to identify and control outbreaks, monitor disease trends, identify pockets of under-immunized populations and to conduct program planning.  State and local public health agencies also submit de-identified data to the CDC.  CDC uses this information to monitor trends and to conduct research and program planning.  Utilizing EHRs to electronically collect and submit this data will increase the efficiency of public health agencies, which in turn will improve patient care.     

The following are clinical cases specific to the 3 objectives of this priority:  

Immunizations. Electronic immunization record data that is available to providers at the point-of-care will help to protect populations from vaccine preventable diseases. State and local public health agencies utilize statewide immunization registries along with Geographical Information System (GIS) mapping software to identify areas for improvement in statewide immunization rates. The American Immunization Registry Association (AIRA) has established a nationwide network of interoperable population-based immunization information systems that helps ensure all people are appropriately immunized. Also, governmental public health agencies can provide alerts and reminders for immunizations through healthcare providers’ EHR systems.

Syndromic Surveillance. Syndromic surveillance is the analysis of medical data to detect or anticipate disease outbreaks.  Syndromic surveillance systems analyze data and monitor symptoms and diseases to give health care providers information at an early stage of an outbreak. Syndromic surveillance tools have been used to track H1N1 and other communicable diseases, and could be used for disease associated with bioterrorism. This information gives providers time-sensitive warnings so they can examine and screen patients effectively to prevent the further spread of disease. For example, if a public health agency identifies an unusual disease pattern that clinical care providers should know about, they send out and alert through CDC’s nationwide Health Alert Network. Early awareness and timely response to the attack is critical to save lives and stop or slow the spread of fatal outbreaks.  

Electronic Lab Reporting. The use of electronic lab reporting protects the community by providing early alerts of potential disease outbreaks.  The electronic reporting of labs, as opposed to paper-based reporting, has been shown to significantly increase the number of lab results reported to governmental public health agencies, improve the speed in which results are received by these agencies, and allow for the collection and submission of more complete data. Lab data can provide governmental public agencies more comprehensive information about local community health issues, disease trends, and outbreaks requiring investigation, and will alert agency staff and healthcare providers to resources that may be needed by these populations.

Related Resources:

Physician Participation Key to Role Immunization Registries Play in Vaccination Efforts go to exit disclaimer– This article from the American Academy of Family Physicians discusses the importance of provider participation in immunization registries and the benefits of registry participation for providers and their patients.  
Potential Effects of Electronic Laboratory Reporting on Improving Timeliness of Infectious Disease Notification – This article in the Morbidity and Mortality Weekly Report (MMWR) demonstrates the clinical case for electronic laboratory reporting.
Foodborne Disease Surveillance and Outbreak Detection go to exit disclaimer– This chapter, written by the Council of State and Territorial Epidemiologists, provides an example of the use of syndromic surveillance as a tool to rapidly detect problems in food and water production and delivery systems.

Developed by the Health Resources and Services Administration as a resource for health centers and other safety net and ambulatory care providers who are seeking to implement health IT.
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