Using Decision Support in Electronic Health Records for Public Health Alerting

The emergence and maturation of the electronic health records as well as the recent passage of the American Recovery and Reinvestment Act (ARRA) provides increasing opportunities to leverage decision support in electronic health record systems for public health.    The Centers for Disease Control and Prevention (CDC), Johns Hopkins University Applied Physics Lab, the University of Utah and GE Healthcare recently demonstrated at the 2009 HIMSS Interoperability Showcase, the capability to create actionable public health alerts capable of being consumed by an electronic health record (EHR) system. In this project, the collaborators explored the feasibility of extending the capability to communicate directly with electronic health record (EHR) systems, using a standard messaging format to create actionable alerts for providers.  These messages  contain sufficient information to identify patients of concern based on the content of the health alert and provide a list of those patients to the provider. The demonstration addressed three key functions: 1) the creation of an “EHR-friendly” alert in an alert repository, 2) the information exchange mechanism, and 3) the EHR system.  The HITSP T81 information exchange construct was used to facilitate the bidirectional exchange of information between public health and the EHR system.  The presentation will provide an overview of the project, examine the extensibility of the approach to other public health domains, and future activities to interoperate with the National Health Information Network and expand the utility of the alert repository.