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Nursing Clinical Information System (NCIS)
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Area of Science:

  • Public Health Informatics
  • Health Information Technology
  • Epidemiological Surveillance

Background:

  • The COVID-19 pandemic exposed limitations in manual public health reporting.
  • A need for a scalable, interoperable health information technology solution was identified.
  • Existing systems created significant clinical and administrative burdens.

Purpose of the Study:

  • To describe the development and nationwide expansion of electronic case reporting (eCR).
  • To evaluate the impact of eCR on public health surveillance and pandemic preparedness.
  • To assess the scalability and interoperability of the eCR infrastructure.

Main Methods:

  • Development and implementation of a standards-based eCR infrastructure (2014-2020).
  • Nationwide scale-up of eCR from January 2020 to January 2023.
  • Assessment of eCR-capable Electronic Health Record (EHR) products, reportable conditions, and connections for healthcare organizations (HCOs) and public health agencies (PHAs).
  • Data quality studies on manual reporting discontinuation and eCR timeliness.

Main Results:

  • eCR-capable EHR products increased 11-fold (3 to 33).
  • Reportable conditions increased 28-fold (6 to 173).
  • Connected HCOs increased 143-fold (153 to 22,000); connected PHAs increased 2.75-fold (24 to 66).
  • eCR timeliness was under 1 minute, with some jurisdictions transitioning to eCR-exclusive reporting.

Conclusions:

  • The expansion of eCR significantly enhances public health surveillance capabilities.
  • eCR provides more timely and complete data compared to manual reporting.
  • The scalable eCR infrastructure reduces reporting burden and improves pandemic readiness.