The US Federal mandate is to implement electronic health records by 2014. While this addresses clinical needs to improve patient care and outcomes and to reduce health care costs, it also provides an opportunity for public health to leverage EHR for surveillance, research, service provision, and preparedness. The National Center on Birth Defects and Developmental Disabilities (NCBDDD) at CDC is in the process of developing an EHR model framework for this purpose.

Public Health (PH) surveillance and research, which has traditionally relied on surveys and epidemiological studies, is now faced with an unprecedented opportunity to utilize data derived from EHRs in order to strengthen the capacity of PH programs to conduct studies on disease etiology and outcomes, and on delivery of health services.  Leveraging this new opportunity is a challenge as several aspects need to be addressed effectively. This session will describe a model framework that can be easily adopted and customized for other conditions and PH purposes. Panelists include scientists from the National Center on Birth Defects and Developmental Disabilities (NCBDDD) at CDC.

At a macro level, development of a PH EHR framework at NCBDDD corresponds with the need for a nationally interoperable HIT infrastructure to address health care reform. Development of an integrated, multi-directional, interoperable EHR system is challenging but achievable, and responds to the ONC’s 2008 HIT Plan and the 2009 ARRA Act. Advancing meaningful use of HIT and establishing EHRs by 2014 will help with development of certified EHR systems. This will help ensure that the needs of populations with unique health concerns (including those targeted by NCBDDD), are effectively served through technology designed for both clinical, and PH applications.

At a micro level, implementation of a PH-oriented EHR framework will provide data and information for use in surveillance, epidemiologic research, longitudinal studies, information monitoring across the lifespan and dissemination of policy guidelines.

Panelists will describe the following key components of NCBDDD’s model framework for EHR:

• Planning: Including research and analyses; collaboration and coordination.
• Development: Including pilot conditions; meaningful use
• Testing and Quality Assurance: Including certification; publication.
• Implementation: Including approaches tailored to proposed models for EHR information on newborn hearing screening, birth defects such as congenital heart defects, and deep vein thrombosis.