J Am Med Inform Assoc - Influenza surveillance using electronic health records in the American Indian and Alaska Native population.

Tópicos

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Resumo

JECTIVE: Increasing use of electronic health records (EHRs) provides new opportunities for public health surveillance. During the 2009 influenza A (H1N1) virus pandemic, we developed a new EHR-based influenza-like illness (ILI) surveillance system designed to be resource sparing, rapidly scalable, and flexible. 4 weeks after the first pandemic case, ILI data from Indian Health Service (IHS) facilities were being analyzed.MATERIALS AND METHODS: The system defines ILI as a patient visit containing either an influenza-specific International Classification of Disease, V.9 (ICD-9) code or one or more of 24 ILI-related ICD-9 codes plus a documented temperature =100?F. EHR-based data are uploaded nightly. To validate results, ILI visits identified by the new system were compared to ILI visits found by medical record review, and the new system's results were compared with those of the traditional US ILI Surveillance Network.RESULTS: The system monitored ILI activity at an average of 60% of the 269 IHS electronic health databases. EHR-based surveillance detected ILI visits with a sensitivity of 96.4% and a specificity of 97.8% based on chart review (N=2375) of visits at two facilities in September 2009. At the peak of the pandemic (week 41, October 17, 2009), the median time from an ILI visit to data transmission was 6 days, with a mode of 1 day.DISCUSSION: EHR-based ILI surveillance was accurate, timely, occurred at the majority of IHS facilities nationwide, and provided useful information for decision makers. EHRs thus offer the opportunity to transform public health surveillance.

Resumo Limpo

jectiv increas use electron health record ehr provid new opportun public health surveil influenza hn virus pandem develop new ehrbas influenzalik ill ili surveil system design resourc spare rapid scalabl flexibl week first pandem case ili data indian health servic ih facil analyzedmateri method system defin ili patient visit contain either influenzaspecif intern classif diseas v icd code one ilirel icd code plus document temperatur f ehrbas data upload night valid result ili visit identifi new system compar ili visit found medic record review new system result compar tradit us ili surveil networkresult system monitor ili activ averag ih electron health databas ehrbas surveil detect ili visit sensit specif base chart review n visit two facil septemb peak pandem week octob median time ili visit data transmiss day mode daydiscuss ehrbas ili surveil accur time occur major ih facil nationwid provid use inform decis maker ehr thus offer opportun transform public health surveil

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