Chronic Disease Surveillance Using Electronic Health Records From Health Centers in a Large Urban Setting

To assess the validity of electronic health records (EHRs) from a network of health centers for chronic disease surveillance among an underserved population in an urban setting.

EHRs from a network of health centers were used to calculate the prevalence of chronic disease among adult and child patient populations during 2016. Two population-based surveys with local estimates of chronic disease prevalence were compared with the EHR prevalences.

A network of health centers that provides health care services to an underserved population in a large urban setting.

A total of 187 292 patients who had at least 1 health care visit recorded in the Philadelphia health center network.

Chronic disease indicator (CDI) prevalence of adult obesity, adult smoking, adult diabetes, adult hypertension, child obesity, and child asthma. Health center CDI proportions were compared with survey estimates.

Overall consistency between the health center estimates and surveys varied by CDI. With the exception of childhood obesity, all health center CDI proportions fell within the 95% CI for at least 1 comparison survey estimate. Statistically significant differences were observed and varied by CDI.

This analysis presents a novel use of existing EHR data to estimate chronic disease prevalence among underserved populations. With the increased use of EHRs in health centers, data from health center networks may supplement chronic disease surveillance efforts, if used appropriately.