BACKGROUND: With the rapidly increasing adoption of electronic health record systems (EHRs) in hospital and ambulatory settings, new data streams may become available to health departments to better understand disease burden and to monitor the impact of interventions. The Centers for Disease Control and Prevention (CDC) Surveillance Strategy provides a plan to improve the timeliness, availability, quality and specificity of surveillance data to CDC programs, health departments and other stakeholders. As data and information of value to public health becomes more available within electronic health data sources, an actionable toolkit will help public health practitioners access and use these data in a consistent manner.
METHODS: The Public Health Informatics Institute (PHII), with funding from CDC, is working with surveillance and informatics experts from federal, state and local levels to develop an online toolkit to support thoughtful, comprehensive planning for surveillance programs using health care data from EHRs. PHII is also working with local and state surveillance programs with experience in working with EHRs to identify lessons learned and promising practices. The toolkit is intended to support planning for any type of surveillance program including those for infectious diseases, chronic conditions, and behavioral risk factors.
RESULTS: The toolkit, slated to ‘go live’ in June 2015, will contain practical, field-tested guidance materials, worksheets and other tools, hosted in an accessible, online repository. It will contain downloadable and modifiable tools to support thoughtful systems planning, and an extensive set of additional resources to provide background information for those interested in increasing their informatics knowledge. The design of the toolkit addresses legal, policy, technical, operational, evaluation and other issues necessary to build or enhance a surveillance program that relies on EHR data. Specific toolkit topics include building the value case, forming lasting partnerships, conducting a legal and policy review, understanding EHR data through workflow analysis, describing technical system options, using and visualizing data, and evaluating surveillance system impacts.
CONCLUSIONS: As EHR systems become more ubiquitous in clinical settings, health departments will have the opportunity to harvest new data for surveillance. Understanding the strengths and limitations of these new data and EHR systems will be critical to future surveillance initiatives.