Public Health Surveillance in Electronic Health Records: Lessons From PCORnet.

IF 4.4 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Preventing Chronic Disease Pub Date : 2024-07-11 DOI:10.5888/pcd21.230417

Nidhi Ghildayal, Kshema Nagavedu, Jennifer L Wiltz, Soowoo Back, Tegan K Boehmer, Christine Draper, Adi V Gundlapalli, Casie Horgan, Keith A Marsolo, Nik R Mazumder, Juliane Reynolds, Matthew Ritchey, Sharon Saydah, Yacob G Tedla, Thomas W Carton, Jason P Block

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引用次数: 0

Abstract

Introduction: PCORnet, the National Patient-Centered Clinical Research Network, is a large research network of health systems that map clinical data to a standardized data model. In 2018, we expanded existing infrastructure to facilitate use for public health surveillance. We describe benefits and challenges of using PCORnet for surveillance and describe case studies.

Methods: In 2018, infrastructure enhancements included addition of a table to store patients' residential zip codes and expansion of a modular program to generate population health statistics across conditions. Chronic disease surveillance case studies conducted in 2019 assessed atrial fibrillation (AF) and cirrhosis. In April 2020, PCORnet established an infrastructure to support COVID-19 surveillance with institutions frequently updating their electronic health record data.

Results: By August 2023, 53 PCORnet sites (84%) had a 5-digit zip code available on at least 95% of their patient populations. Among 148,223 newly diagnosed AF patients eligible for oral anticoagulant (OAC) therapy, 43.3% were on any OAC (17.8% warfarin, 28.5% any novel oral anticoagulant) within a year of the AF diagnosis. Among 60,268 patients with cirrhosis (2015-2019), common documented etiologies included unknown (48%), hepatitis C infection (23%), and alcohol use (22%). During October 2022 through December 2023, across 34 institutions, the proportion of COVID-19 patients who were cared for in the inpatient setting was 9.1% among 887,051 adults aged 20 years or older and 6.0% among 139,148 children younger than 20 years.

Conclusions: PCORnet provides important data that may augment traditional public health surveillance programs across diverse conditions. PCORnet affords longitudinal population health assessments among large catchments of the population with clinical, treatment, and geographic information, with capabilities to deliver rapid information needed during public health emergencies.

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电子健康记录中的公共卫生监控：PCORnet 的经验教训。

简介国家以患者为中心临床研究网络（PCORnet）是一个由卫生系统组成的大型研究网络，它将临床数据映射到标准化数据模型中。2018 年，我们扩展了现有基础设施，以方便用于公共卫生监测。我们介绍了使用 PCORnet 进行监测的益处和挑战，并描述了案例研究：2018 年，我们对基础设施进行了改进，包括增加了一个用于存储患者居住地邮政编码的表格，并扩展了一个模块化程序，以生成各种情况下的人口健康统计数据。2019 年开展的慢性病监测案例研究对心房颤动 (AF) 和肝硬化进行了评估。2020 年 4 月，PCORnet 建立了支持 COVID-19 监测的基础设施，各机构经常更新其电子健康记录数据：到 2023 年 8 月，53 个 PCORnet 站点（84%）至少有 95% 的患者人口拥有 5 位数邮政编码。在 148,223 名符合口服抗凝剂 (OAC) 治疗条件的新确诊房颤患者中，43.3% 的患者在确诊房颤后一年内服用过任何一种 OAC（17.8% 为华法林，28.5% 为任何一种新型口服抗凝剂）。在 60,268 名肝硬化患者（2015-2019 年）中，有记录的常见病因包括病因不明（48%）、丙型肝炎感染（23%）和饮酒（22%）。在 2022 年 10 月至 2023 年 12 月期间，34 家机构的 887 051 名 20 岁或以上的成人和 139 148 名 20 岁以下的儿童中，在住院环境中接受护理的 COVID-19 患者比例分别为 9.1%和 6.0%：PCORnet 提供了重要的数据，可增强传统的公共卫生监测计划，监测各种疾病。PCORnet 可通过临床、治疗和地理信息对大量人口进行纵向人口健康评估，并可在公共卫生突发事件中提供所需的快速信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Preventing Chronic Disease PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.70

自引率

3.60%

发文量

期刊介绍： Preventing Chronic Disease (PCD) is a peer-reviewed electronic journal established by the National Center for Chronic Disease Prevention and Health Promotion. The mission of PCD is to promote the open exchange of information and knowledge among researchers, practitioners, policy makers, and others who strive to improve the health of the public through chronic disease prevention. The vision of PCD is to be the premier forum where practitioners and policy makers inform research and researchers help practitioners and policy makers more effectively improve the health of the population. Articles focus on preventing and controlling chronic diseases and conditions, promoting health, and examining the biological, behavioral, physical, and social determinants of health and their impact on quality of life, morbidity, and mortality across the life span.