New Electronic System Improves Infectious Illness Reporting

A new electronic medical record reporting system helps clinicians detect contagious illnesses and automatically report them to public health departments, providing more complete, timely and accurate disease reports to prevent the spread of infectious illnesses and reduce clinicians’ workload.

Typically, clinicians report diseases by filling out paper forms and mailing or faxing them to health authorities, a time-consuming process that can lead to delays in reporting and even failure to report some cases altogether. The new system, Electronic Medical Record Support for Public Health (ESP), saves time by automatically scanning electronic medical records to identify cases and report them to the health department on the clinician’s behalf.

Researchers at Harvard Pilgrim Health Care, Harvard Medical School, Atrius Health and the Massachusetts Department of Public Health created and tested the new system. The pilot version was installed January 2007 at Atrius Health, a multi-specialty physician group with 30 practice sites in Eastern Massachusetts.

“ESP offers the promise of more rapid detection of threats to the public health,” said Alfred DeMaria Jr., M.D., director of the Bureau of Communicable Disease Control at the Massachusetts Department of Public Health. “This would allow faster action to prevent further transmission of infection.”

ESP substantially increased the number of reported infections and the completeness of information sent to health officials. For example, the system reported approximately 40 percent more Chlamydia cases and 50 percent more gonorrhea cases within a one-year period. ESP also improved reporting whether infected patients were pregnant and whether correct antibiotics had been prescribed.

The system currently reports seven types of infection: active tuberculosis, Chlamydia, gonorrhea, pelvic inflammatory disease and acute hepatitis A, B and C. Researchers are developing methods to detect and report additional kinds of infections.

Richard Platt, senior author of the study and chairman of the Harvard Medical School Department of Ambulatory Care and Prevention at Harvard Pilgrim Health Care, points out that ESP also reduces the amount of work required of busy practitioners.

“This is a good example of the ways clinicians can provide better support for public health activities that benefit everyone,” he said.

An estimated 45 percent of clinicians in Massachusetts use an electronic medical record, a number expected to rise to 75 percent by 2010.

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