Staff Experiences With Electronic Initial Case Reports for Birth Defects Surveillance in Texas

Electronic case reporting (eCR) is increasingly used by public health agencies to support disease surveillance. Its utility for birth defects surveillance remains unexplored. This project aimed to evaluate birth defects surveillance staff experiences and perceptions of eCR data to identify its challenges, benefits, and opportunities for improvement in birth defects surveillance.

Two virtual, 1-h focus groups were conducted with 15 staff from the Texas Birth Defects Registry (TBDR) who had participated in a pilot evaluation of electronic initial case reports (eICRs). The focus groups explored staff experiences with identifying and abstracting cases from eICRs and how these experiences compared to abstraction from electronic health records (EHRs). Discussions followed a structured interview guide with six broad question categories. Detailed notes were taken during the sessions and analyzed using thematic analysis to identify common themes and patterns.

Thematic analysis identified six key themes related to the eICR: Structure; Quality and Completeness; Comparison with EHRs; Technical and Workflow Challenges; Usefulness and Potential Applications; and Recommendations to Strengthen its Utility for Birth Defect Surveillance.

Staff reported that while eCR offers potential advantages, such as serving as a data source for case-finding, significant challenges remain. These include issues with eICR structure, data completeness, and integration into existing workflows. Recommended improvements include better organization of eICR data, inclusion of additional clinical details, and development of standardized abstraction protocols. These findings can inform strategies to optimize eCR for birth defects surveillance and point to the need for national guidelines.