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Public Health Informatics Virtual Event Day Three

January 9, 2014
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NYC Macroscope using EHRs for population health surveillance

Healthcare Informatics has written several articles highlighting the valuable work of the Primary Care Information Project (PCIP), which has created a data reporting and physician alert infrastructure, grounded in an electronic hub platform (co-developed with eClinicalWorks). It allows the New York City Department of Health to gather information on the prevalence of both acute disease outbreaks and of levels of chronic disease in different neighborhoods across New York City.

During the final day of the Public Health Informatics Virtual Event on Jan. 9, Remle Newton-Dame, an epidemiologist for the New York City Department of Health, described a project that builds on PCIP. NYC Macroscope is a population health surveillance system that uses EHRs to track conditions managed by primary care practices that are important to public health. Using the NYC Macroscope, the department will be able to monitor in real-time the prevalence of chronic conditions, such as obesity, diabetes and hypertension, as well as smoking rates and flu vaccine uptake. It is another reminder of the potential of connected EHRs to create a learning health system.

Research about Macroscope will help epidemiologists identify best practices for harnessing EHR data for population health improvement efforts, Newton-Dame said. It will validate the EHR data from PCIP by comparing ambulatory EHR data with data from the 2013 NYC Health and Nutrition Examination Survey, a gold-standard, population-based health survey, she said. “Results from bio-measurement have real policy power and real influence,” she said. “We hope that EHR data can start to have that influence without as much effort and cost as efforts such as HANES.” The lessons learned in developing the NYC Macroscope could be useful to other agencies and researchers interested in using EHRs to monitor population health, she said.

One of the overall purposes of Macroscope, she said, is to understand the extent to which the EHR data can be blended with other data sets. For instance, flu and gastrointestinal disease information is being sent to syndromic surveillance monitors. It may allow for the combination of asthma reports and air quality data by Zip code. PCIP gathers data on approximately 15 to 18 percent of New York adults under the care of primary care physicians, she said.

With the wrap-up of the Virtual Event, the next big in-person meeting on the topic is the 2014 Public Health Informatics Conference, April 29- May 1, 2014 in Atlanta, sponsored by the Centers for Disease Control and Prevention and the National Association of County and City Health Officials.