BACKGROUND: With many health departments facing limited resources, electronic case reporting (eCR) of diseases may become the preferred method of data transfer. To assist in epidemiologic investigations and case reporting, the Utah Department of Health (UDOH) has implemented an automated case reporting system where data elements important to public health case investigations are transferred directly from provider electronic health records (EHR) to the state surveillance system. Here we discuss recent progress in eCR for sexually transmitted infections.
METHODS: Diagnosis and laboratory codes that trigger eCR have been programmed into Planned Parenthood Association of Utah’s (PPAU) EHR for the sending of information on gonorrhea, chlamydia, syphilis, and HIV cases. Once triggered, data elements important to public health case investigations are received and processed through UDOH’s rules engine and brought directly into UDOH’s national electronic disease surveillance system. Data elements required for case investigation and case closure are now automatically appended to a case. Additionally, a time-motion (T-M) study was conducted showing that PPAU staff spent a significant amount of time per positive STD case manually reporting clinical data (including demographics and treatment) to public health agencies.
RESULTS: In the first two months of eCR transmissions, UDOH received 280 triggered case files from PPAU, with 231 cases being updated in UDOH’s surveillance system. Cases are only updated with new information. Forty-five data elements including patient demographics, treatment information, lab data, and diagnosis codes, can be appended to the notes of a case; these variables can be used to supplement data not routinely captured through electronic lab reporting. Baseline T-M results show that approximately 120 hours could be saved (the equivalent of 480 individual clinic appointments) if clinical data elements could be sent via electronic methods rather than manual methods.
CONCLUSIONS: Successful eCR has been implemented at UDOH and quality assurance (QA) continues to improve the data being received. The automated process can decrease the time spent obtaining case data, and increase timeliness and completeness by eliminating paper forms manually sent and received by providers and public health agencies. eCR will be essential for conditions that require clinical symptom observations and/or clinician diagnoses for case classification. Future development will make it possible for eCR to not only update cases, but to create new cases. A follow-up T-M study will be conducted when QA is complete.