Related Experiment Video
Updated: May 23, 2026
06:55
A High-throughput Platform for the Screening of Salmonella spp./Shigella spp.
Published on: November 7, 2018
Gastrointestinal disease outbreak detection using multiple data streams from electronic medical records.
Sharon K Greene1, Jie Huang, Allyson M Abrams
1Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215-3920, USA. Sharon_Greene@harvardpilgrim.org
Foodborne Pathogens and Disease
|March 21, 2012
Summary
Electronic medical records (EMRs) can enhance gastrointestinal (GI) disease surveillance. Analyzing EMR data streams, including lab results and diagnoses, helps detect potential outbreaks faster than traditional methods.
Area of Science:
- Public Health Surveillance
- Infectious Disease Epidemiology
- Health Informatics
Background:
- Passive reporting and lab delays hinder gastrointestinal (GI) disease outbreak detection.
- Electronic medical records (EMRs) offer a rich source of clinical data for surveillance.
- This study aimed to identify optimal EMR data streams for GI outbreak detection.
Purpose of the Study:
- To identify and evaluate electronic medical record (EMR) data streams for effective gastrointestinal (GI) disease outbreak surveillance.
- To assess the performance of various syndromic and laboratory data streams within EMRs for public health monitoring.
Main Methods:
- Utilized Kaiser Permanente Northern California EMR data from 2009 for 3.3 million members.
- Analyzed 22 syndromic and laboratory data streams, including diagnosis codes, medication dispensings, and microbiology tests.
- Employed space-time permutation scan statistics for prospective daily surveillance and cluster identification.
Main Results:
- Identified 28 potential outbreaks using single-stream analyses, with outpatient diagnosis codes being the most frequent signal.
- Detected specific outbreaks, including a cluster of stool cultures and a Salmonella outbreak with a rare serotype.
- Multi-stream analyses revealed additional outbreaks and improved detection timeliness in some instances.
Conclusions:
- EMR data streams, particularly microbiology tests, stool culture orders, and outpatient diagnoses, are valuable for GI outbreak detection.
- This EMR-based surveillance can supplement traditional public health reporting, especially for outbreaks lacking laboratory confirmation.
- Identifying clusters of positive microbiology tests in EMRs can prioritize state health department testing and enhance overall outbreak detection capabilities.
Related Concept Videos
01:23Investigation of Disease Outbreaks
Multistate foodborne outbreaks pose significant public health risks and require meticulous investigation to identify sources and implement control measures. The Centers for Disease Control and Prevention (CDC) utilizes a dynamic seven-step process for these investigations, integrating data from laboratories, interviews, and environmental assessments to protect public health.Outbreak Detection: The detection of multistate outbreaks typically begins with PulseNet, the CDC's national laboratory...
01:18Steps in Outbreak Investigation
In the ever-evolving field of public health, statistical analysis serves as a cornerstone for understanding and managing disease outbreaks. By leveraging various statistical tools, health professionals can predict potential outbreaks, analyze ongoing situations, and devise effective responses to mitigate impact. For that to happen, there are a few possible stages of the analysis:
01:30Methods of Documentation VII: EMR
Electronic Medical Records (EMRs) primarily center around electronically documenting patients' health information within a single healthcare organization or practice. They contain essential clinical data related to a patient's medical history, diagnoses, medications, treatment plans, lab results, and other pertinent information relevant to the specific encounter or episode of care. EMRs are designed to streamline documentation and workflow processes within individual healthcare settings,...
01:26Principles of Disease Surveillance
Disease surveillance is the systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice. This process integrates data dissemination to entities responsible for preventing and controlling disease, injury, and disability. Surveillance systems provide crucial information for action, helping public health authorities make informed decisions to manage and prevent outbreaks, ensure public safety, optimize...
01:18Bacterial Gastroenteritis
Bacterial gastroenteritis, characterized by diarrhea, abdominal cramps, and vomiting, is often caused by ingestion of contaminated food or water and is frequently associated with pathogenic Escherichia coli strains. These microbes exploit two principal mechanisms to inflict disease.Shiga toxin–producing E. coli, also referred to as STEC—notably O157:H7—release Shiga toxins that target ribosomes, blocking protein synthesis. The B subunit of the toxin binds the host glycolipid receptor...
01:24Automated Microbial Diagnostics
Automated diagnostic analyzers have transformed clinical microbiology by providing rapid and reliable methods for pathogen identification and antibiotic susceptibility testing. Among these systems, the Vitek 2 is widely used because it automates the traditionally labor-intensive processes of microbial identification (ID) and antibiotic susceptibility testing (AST), delivering standardized and timely results that are essential for effective patient care.Microbial Identification with ID CardsThe...