492. What’s Going Around? The Use of Electronic Health Records to Perform Context-Specific Real-Time Syndromic Surveillance
Session: Poster Abstract Session: Public Health
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
  • WGA IDweek poster.pdf (747.1 kB)
  • Title: What's Going Around? The Use of Electronic Health Records to Perform Context-Specific Real-Time Syndromic Surveillance

    Background: Knowledge of a patient's epidemiological context can aid clinicians in diagnosis and treatment of conditions such as Influenza-Like Illness (ILI).  Syndromic surveillance is currently performed by public health agencies, but this information is not available readily or rapidly to treating clinicians.  With advanced electronic health records (EHRs), it is increasingly possible to perform syndromic surveillance that is local (e.g. specific to a neighborhood or school district), current (e.g. updated daily), and specific to a patient's characteristics (e.g. age, chief complaint).

    Methods: At our 4-hospital, 850-physician health system, there are approximately 2,000 primary care outpatient and ER encounters per day. All data regarding patient demographics, chief complaint, physical exam, note text, diagnoses, and laboratory results are collected into an Enterprise Data Warehouse (EDW) and are geographically linked to a patient's residence. Data in the EDW can be queried and synthesized in a near real-time manner. We used EDW data to develop syndromic surveillance algorithms (which include chief complaint, diagnoses, vital signs, test ordering patterns and laboratory results) to track disease activity within our community for several conditions, including ILI, asthma, and pertussis.

    Results: The syndromic surveillance algorithms revealed temporal trends in disease activity. We validated our algorithms using external data. For example, the pertussis algorithm results closely matched the cases of pertussis reported to the Illinois Department of Public Health (IDPH) in our catchment area over time (Figure 1).  These algorithms are fully automated, and their results can be displayed on demand to clinicians in the context of the EHR, including heatmaps representing syndromic intensity in regions relevant to the patient being evaluated. (See Figure 2 for  heatmaps of ILI activity during various time points from 2009-2010).  

    Conclusion: A health system's EHR can be used to track epidemiology and syndromic activity among its patient population. This can be used to provide clinicians with local and timely epidemiological data to help guide clinical decision making.


    Jessica P. Ridgway, MD1, Eric C. Brown, PhD2, Chad Konchak2 and Ari Robicsek, MD2, (1)University of Chicago, Chicago, IL, (2)Northshore University Healthsystem, Evanston, IL


    J. P. Ridgway, None

    E. C. Brown, None

    C. Konchak, None

    A. Robicsek, None

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