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ISDS 2012 Conference Abstracts

A Web-based Electronic Health Record System for
National Surveillance
Jake R. Marcus*

Practice Fusion, San Francisco, CA, USA

Objective
This showcase aims to demonstrate the viability of Practice Fu-

sion’s web-based electronic health record system for national sur-
veillance. Practice Fusion also wishes to provide aggregate data to
public health departments for surveillance for free. This showcase
also hopes to engage those potential partners around uses of the com-
pany’s research database.

Introduction
Practice Fusion is a web-based electronic health record system

with over 150,000 medical professional users treating over 50 million
patients. The company focuses on small, ambulatory practices and is
predominately comprised of practices in the field of primary care.
The user base makes it an ideal system for public health surveillance.
The Research Division has undertaken pilot projects to demonstrate
the viability of using the data for surveillance for acute diseases, like
influenza-like illness, chronic diseases, like diabetes, and risk fac-
tors, like hypertension.

Methods
Surveillance systems based on electronic health records have clear

advantages over case based reporting, but the majority of those sys-
tems are limited to the small geographical area affiliated with the hos-
pital or health plan associated with the project. Practice Fusion has
coverage in all 50 states and runs on a single, multi-tenant database
making comparisons across those states and the localities within them
immediately feasible. The company wishes to engage the organiza-
tions represented at ISDS in order to advance public health surveil-
lance using the research database. It is very difficult to obtain
electronic health record data currently, but with the appropriate data

use agreement Practice Fusion believes that it is a moral imperative
to use its aggregate data for surveillance. The Research Division has
developed methods for the surveillance of influenza-like illness with
its system and comparisons to the CDC have proven its viability.

Conclusions
By comparing trends and levels of influenza-like illness generated

from Practice Fusion’s research database to Google Flu Trends and
the gold standard estimates produced by the CDC, web-based elec-
tronic health record systems have proved to be a viable foundation for
syndromic surveillance. The implementation of the system also
shows that case definitions for surveillance need not be overly sim-
plistic if they do not require cases to be submitted from physicians,
but rather can be programmed to be identified through automated al-
gorithms.

Keywords
public health surveillance; electronic health record; Practice Fusion

Acknowledgments

The data team at Practice Fusion

References

www.practicefusion.com
research.practicefusion.com

*Jake R. Marcus
E-mail: jmarcus@practicefusion.com

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 5(1):e204, 2013