Syndromic Surveillance Using Ambulatory Electronic Health Records Health Records
Syndromic Surveillance Using Ambulatory Electronic Health Records Health Records
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DOI：
10.1197/jamia.m2922
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发表时间：
2009-05-01
影响因子：
6.4
通讯作者：
Mostashari, Farzad
中科院分区：
文献类型：
--
作者：
Hripcsak, George;Soulakis, Nicholas D.;Mostashari, Farzad
目的：为了评估电子健康记录数据的综合征监测的性能，并评估广泛分布的Surveillance.Design的可行性：两个系统的开发，以确定流感样疾病和胃肠道传染病的动态电子健康记录数据从网络的社区卫生中心。第一个系统使用结构化数据查询，并专为这种特定的电子健康记录而设计。第二个使用自然语言处理叙述数据，但其查询独立于此健康记录。这两种方法都与流感病毒分离株和经验证的急诊科主任投诉监测系统进行了比较。测量结果：三个时间序列的滞后互相关和图表。对于流感样疾病，结构化和叙述性数据与流感分离株和急诊科数据相关性良好，分离株的交叉相关性为0.89（结构性）和0.84（叙述性），急诊科数据的交叉相关性为0.93和0.89，并且在流感季节期间具有相似的峰值。对于消化道感染性疾病，结构化数据与急诊科数据的相关性较好（0.81），峰值相似，但叙述性数据的相关性较差（0.47）。结论：电子健康档案用于症状监测是可行的。结构化数据表现最好，但需要知识工程来匹配健康记录数据的查询。叙述性数据说明了广泛传播的系统的潜在绩效，并取得了好坏参半的结果。美国医学信息协会杂志2009;16：354-361。DOI 10.1197/jamia.M2922.
Objective: To assess the performance of electronic health record data for syndromic surveillance and to assess the feasibility of broadly distributed Surveillance.Design: Two systems were developed to identify influenza-like illness and gastrointestinal infectious disease in ambulatory electronic health record data from a network of community health centers. The first system used queries on structured data and was designed for this specific electronic health record. The second used natural language processing of narrative data, but its queries were developed independently from this health record. Both were compared to influenza isolates and to a verified emergency department chief complaint surveillance system.Measurements: Lagged cross-correlation and graphs of the three time series.Results: For influenza-like illness, both the structured and narrative data correlated well with the influenza isolates and with the emergency department data, achieving cross-correlations of 0.89 (structured) and 0.84 (narrative) for isolates and 0.93 and 0.89 for emergency department data, and having similar peaks during influenza season. For gastrointestinal infectious disease, the structured data correlated fairly well with the emergency department data (0.81) with a similar peak, but the narrative data correlated less well (0.47).Conclusions: It is feasible to use electronic health records for syndromic surveillance. The Structured data performed best but required knowledge engineering to match the health record data to the queries. The narrative data illustrated the potential performance of a broadly disseminated system and achieved mixed results. J Am Med Inform Assoc. 2009;16:354-361. DOI 10.1197/jamia.M2922.