A Prototype Implementation of An Alert Knowledge Repository

With rising incidences of foodborne disease outbreaks and looming threat of pandemic infectious disease, new approaches are needed to improve communication of public health alerts between public health officials at the local, state and national level and clinicians treating patients. One approach to address these problems is to leverage the increasing presence of Electronic Medical Record systems in healthcare organizations.

Our proposed approach is to organize all public health alerts in a nationwide alert repository. Using the patient data loaded in an EMR, a clinician can trigger an automated query of the alert repository composed of an anonymized form of the patient profile. The knowledge repository sends back all active public health alerts pertaining to the details of the patient. Alerts retrieved in this fashion contain the alert details, diagnostic procedures, treatment options, and contact information. The EMR system records the alerts viewed by the clinician for further reference, and provides a mechanism to allow the clinician to give feedback as to which alerts were relevant. This feedback is conveyed back to the alert repository, providing public health officials with data on alert usage and potential new cases.

To test this approach, we have built a prototype alert repository that represents each alert as a set of fixed value and free form data fields. Demonstrated as part of the Interoperability Showcase at the HIMSS09 conference, this prototype implements the T.81 HITSP specification to allow any compliant EMR to perform patient queries, and includes a convenient web interface for managing alerts.

In this presentation we will describe our proposed approach to public health alerting, appraise that approach, and demonstrate our prototype knowledge repository in use with an EMR system.