Electronic health record case studies to advance environmental public health tracking

Abstract

Data from traditional public health surveillance systems can have some limitations, e.g., timeliness, geographic level, and amount of data accessible. Electronic health records (EHRs) could present an opportunity to supplement current sources of routinely collected surveillance data. The National Environmental Public Health Tracking Program (Tracking Program) sought to explore the use of EHRs for advancing environmental public health surveillance practices. The Tracking Program funded four state/local health departments to obtain and pilot the use of EHR data to address several issues including the challenges and technical requirements for accessing EHR data, and the core data elements required to integrate EHR data within their departments' Tracking Programs. The results of these pilot projects highlighted the potential of EHR data for public health surveillance of rare diseases that may lack comprehensive registries, and surveillance of prevalent health conditions or risk factors for health outcomes at a finer geographic level. EHRs therefore, may have potential to supplement traditional sources of public health surveillance data.

Common and Unique Barriers to the Exchange of Administrative Healthcare Data in Environmental Public Health Tracking Program

“…EHR data tend to be more timely than data from traditional public health surveys or systems and can be available at a finer geographic level [ 20 ]. A recent study provided evidence of nationwide surveillance of asthma prevalence and asthma ED visits using EHR data from a multisite collaboration across the US [ 21 , 22 , 23 ]. Asthma prevalence estimates produced using EHR data were comparable to those produced using data from established national and state-level surveys [ 21 ].…”

“…Asthma prevalence estimates produced using EHR data were comparable to those produced using data from established national and state-level surveys [ 21 ]. Timely health outcome data can support responses to public health incidents such as wildfires, extreme heat, or other extreme weather events [ 23 ], and Tracking Program partners could explore obtaining EHR data in collaboration with their state recipients for more timely administrative data at a finer geographic level than county.…”

An exposomic framework to uncover environmental drivers of aging

“…Personal health records, like electronic health records (EHRs), also provide a means to estimate exposures on a personal level, such as exposure to pharmaceutical drugs, recreational drugs, alcohol, or cigarette smoke. EHR also provide the aging relevant outcome data [ 50 ].…”

Artificial Intelligence for Surveillance in Public Health

“…Hospital databases are clearly a source for surveillance which is increasingly considered 12 13 14 . A good review 15 shows pilot studies of public health surveillance of chronic diseases and risk factors performed in several states of the United States. The topics were type 2 diabetes (based on hemoglobin A1c), pediatric asthma, amyotrophic lateral sclerosis, obesity, and smoking.…”