Chlamydia and gonorrhea are the two most commonly reported notifiable diseases in the U.S. and in Chicago. In 2013, Chicago’s chlamydia rate (924.7/100,000 population) was two times higher than the national rate, and the gonorrhea rate (311.3/100,000 population) was approximately three times higher.
The Chicago Department of Public Health (CDPH) utilizes the Illinois National Electronic Disease Surveillance System (I-NEDSS), a web-based application managed by the Illinois Department of Public Health (IDPH), for disease reporting and surveillance. Providers report cases to CDPH by submitting paper forms that CDPH staff manually enter into I-NEDSS or by directly entering the case into I-NEDSS. Case reporting requires manual data entry which leads to untimely, incomplete and inaccurate data.
Electronic case reporting (eCR) using electronic health records (EHR) has been reported to increase the number, accuracy, completeness and timeliness of case reports. The objective of this project is to generate chlamydia and gonorrhea case reports from EHR systems managed by Alliance of Chicago (AOC), and electronically submit these case reports to I-NEDSS.
METHODS:
AOC is a network of community health centers that reported 12.4% (4151/33358) of Chicago's chlamydia and gonorrhea cases in 2013. Because of AOC’s capacity in health information technology and significant chlamydia and gonorrhea morbidities, CDPH partnered with AOC for this initiative. CDPH’s Health Systems Integration Program Fellow spent 20% of her time at AOC to work directly on this project.
RESULTS: A stand-alone application was developed to extract and transmit files containing mandated fields of sexually transmitted infection (STI) case reports from AOC's EHR systems to I-NEDSS, algorithms were developed to define cases based on positive laboratory results, and EHR data were mapped to required I-NEDSS case report fields. The application has been tested in one of AOC's 11 Chicago community health centers' databases and produced test case reports with the plan to expand to all AOC's databases.
CONCLUSIONS: This eCR initiative will relieve the burden of processing paper-based chlamydia and gonorrhea case reports for both AOC providers and CDPH STI surveillance staff. Some outcomes from this project include strengthening partnerships between CDPH and AOC as well as between CDPH and IDPH, and helping CDPH understand and IDPH refine I-NEDSS requirements for these communications which will ultimately be utilized for future eCR projects. This project is still underway, but hopefully eCR will improve the timeliness and completeness of surveillance case reports, and therefore, public health actions can be directed more promptly to the populations in need.