Researchers at DACP, Atrius Health and the Massachusetts Department of Public Health have created a set of computer programs that use electronic medical records to help clinicians detect contagious illness and automatically report these illnesses to public health departments. The US Centers for Disease Control and Prevention (CDC) sponsored these efforts, e.g., funding the Boston-based Center for Excellence in Public Health Informatics that Dr. Richard Platt, Chairman of the DACP, leads. The new system, called Electronic Medical Record Support for Public Health, or ”ESP,” was highlighted in the April 11 issue of Morbidity and Mortality Weekly Report, a publication of the CDC. The pilot version of ESP was installed in January 2007 at Atrius Health in Massachusetts.
The ESP program improves the speed and efficiency of reporting diseases like tuberculosis and viral hepatitis to public health authorities. Clinicians have traditionally reported diseases by filling out paper forms and mailing or faxing them to health authorities. This time-consuming work leads to delays in disease reporting and failure to report some cases altogether. The new system will save time by automatically scanning electronic medical records to identify cases and electronically report them to the health department on clinicians’ behalf. Plus, ESP provides more complete, timely, and accurate disease reports.
Dr. Platt, principal investigator for the project said: “This is a good example of the way clinicians can provide better support for public health activities that benefit everyone. It is especially noteworthy that this system also reduces the amount of work required of busy practitioners.”
In its first year of practice, ESP increased both the number of reported infections and the completeness of information sent to health officials. The new system reported approximately 40% more cases of chlamydia and 50% more cases of gonorrhoea. In addition, ESP did a better job of reporting if the infected patient was pregnant (and hence high priority for ensuring appropriate treatment) and whether correct antibiotics had been prescribed. ESP is currently reporting seven different infections: active tuberculosis, acute hepatitis A, acute hepatitis B, and acute hepatitis C, chlamydia, gonorrhoea and pelvic inflammatory disease. The research team is developing methods to detect and report additional kinds of infections. Public health officials hope that ESP will become a model for improving disease surveillance throughout the country.
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