Public Health Surveillance in Electronic Health Records: Lessons From PCORnet

Area of Science:

• Health Informatics
• Public Health Surveillance
• Clinical Research Networks

Background:

• PCORnet, a national research network, standardizes clinical data across health systems.
• Infrastructure was expanded in 2018 to support public health surveillance initiatives.
• The network facilitates population health statistics generation and disease surveillance.

Purpose of the Study:

• To describe the benefits and challenges of utilizing PCORnet for public health surveillance.
• To present case studies of chronic disease and infectious disease surveillance using PCORnet data.
• To evaluate the utility of PCORnet for real-time public health monitoring.

Main Methods:

• Infrastructure enhancements included adding residential zip codes and expanding a modular statistics program.
• Case studies on atrial fibrillation (AF) and cirrhosis were conducted in 2019.
• An infrastructure for COVID-19 surveillance was established in April 2020, with frequent data updates.

Main Results:

• By August 2023, 84% of PCORnet sites had 5-digit zip codes for over 95% of patients.
• Among newly diagnosed AF patients, 43.3% received oral anticoagulant therapy within a year.
• Cirrhosis etiologies included unknown (48%), hepatitis C (23%), and alcohol use (22%).
• During Oct 2022-Dec 2023, inpatient COVID-19 rates were 9.1% for adults and 6.0% for children.

Conclusions:

• PCORnet data can augment traditional public health surveillance programs.
• The network enables longitudinal population health assessments with clinical, treatment, and geographic data.
• PCORnet offers capabilities for rapid information delivery during public health emergencies.