Electronic Data Validation for Ilinet Sites – Maine

BACKGROUND:  The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) is a joint effort between states and federal CDC to monitor information on patient visits to health care providers for influenza-like illness.  ILINet consists of more than 3,000 healthcare providers in all 50 states, the District of Columbia and the U.S. Virgin Islands reporting over 30 million patient visits each year.  Maine has approximately 30 ILINet providers that contribute data to this system.  Maine’s providers are split between sites that collect the data manually, and sites that use electronic data sources to automate the process.  All sites that wish to use electronic data sources must undergo evaluation before being included into ILINet.

METHODS:  After identifying a site with an Electronic Medical Record (EMR), the site is requested to generate multiple queries from the EMR to determine the most sensitive method of extraction.  Two years of historical data are extracted, and compared to other external sources of data (including existing manual data from the same site, other ILINet sites, syndromic surveillance, and hospital surveillance).  If the data appears to be a good match, the data is forwarded to federal CDC for validation.  Once a site is validated, steps are taken to automate the process as much as possible.

RESULTS:  To date, 14 sites have been validated for inclusion in ILINet, with 16 additional sites in progress.  These sites combined reported over 56,000 patient visits during the 2011-2012 influenza season, helping create a robust surveillance system within the state.

CONCLUSIONS:   Validation of electronic data sources helps standardize reporting, as well as ease burdens on partners for reporting.  All validated sites are currently using standardized ICD-9 codes that are influenza specific.  This decreases the signal seen by ILINet providers because it is very specific and may miss cases that are not coded as influenza.  Education on proper coding is essential and is ongoing with participating sites.  Automation is a major benefit to electronic data validation as the system can function without requiring human input, ensuring that reporting is consistently on time, and rarely interrupted.  Additional work is ongoing to improve the process, validate existing sites, and enroll additional sites.