Public Health Surveillance Using Electronic Health Records: Rising Potential to Advance Public Health
Public Health Surveillance Using Electronic Health Records: Rising Potential to Advance Public Health
复制标题
使用电子健康记录进行公共卫生监测：促进公共卫生的潜力不断增加
DOI：
10.13023/fphssr.0405.05
复制
发表时间：
2015
影响因子：
5.2
通讯作者：
N. Shah
中科院分区：
文献类型：
--
作者：
G. Birkhead;M. Klompas;N. Shah
背景：公共卫生监测传统上依赖于人工流程，包括临床医生的纸质报告。电子实验室报告的引入提高了传染病监测的效率和完整性，但临床和风险因素数据往往仍需人工收集。电子健康记录（EHR）的使用在通过自动收集这些数据以及将监测范围扩大到慢性病（如糖尿病、高血压、肥胖症）来丰富监测方面具有重大前景。然而，电子健康记录用于公共监测的程度尚未得到充分研究。
证据获取：在同行评审的医学文献中搜索有关电子健康记录用于公共卫生监测的描述。
证据综合：此类文献非常有限。最大规模的研究描述了目前在马萨诸塞州、俄亥俄州和得克萨斯州使用的公共卫生电子病历支持系统（ESPnet）的经验。它展示了使用电子健康记录进行监测的潜力和挑战。
讨论：将电子健康记录数据常规纳入监测为扩大监测工作的广度、质量和效率提供了独特的机会。然而，需要更多的研究来记录电子健康记录的潜在益处和局限性。
启示：监测从业者应与卫生系统和电子健康记录供应商合作，探索电子健康记录的使用。政策制定者应通过在“有意义使用”和其他倡议中制定要求，增加对基于电子健康记录的监测的财政支持。此外，临床医学和公共卫生应共同努力，制定有意义的监测措施，以便同时改善个人和人群的医疗保健。
Background: Public health surveillance has traditionally relied on manual processes including paper-based reporting by clinicians. The introduction of electronic laboratory reporting increased the efficiency and completeness of infectious disease surveillance but clinical and risk factor data are often still collected manually. The use of electronic health records (EHR) has significant promise to enrich surveillance by collecting these data automatically and by expanding surveillance to chronic diseases (e.g., diabetes, hypertension, obesity). However, the extent of the use of EHRs for public surveillance is not well studied. Evidence Acquisition: The peer-reviewed medical literature was searched for descriptions of the use of EHRs for public health surveillance. Evidence Synthesis: This literature is very limited. The largest body of work describes the experience of the Electronic Medical Record Support for Public Health system (ESPnet) currently being used in Massachusetts, Ohio, and Texas. It shows both the potential and challenges of using EHRs for surveillance. Discussion: Routine incorporation of EHR data into surveillance provides a unique opportunity to expand the breadth, quality, and efficiency of surveillance efforts. However, more research is needed to document the potential benefits and limitations of EHRs. Implications: Surveillance practitioners should work with health systems and EHR vendors to explore the use of EHRs. Policymakers should increase financial support for EHR-based surveillance by building requirements into Meaningful Use and other initiatives. In addition, clinical medicine and public health should work together to develop meaningful surveillance measures that can simultaneously improve the care of individuals and populations.