2014.ISDS.Abstracts.Final.pdf


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ISDS 2014 Conference Abstracts

Electronic Health Records and Environmental Public 
Health Tracking

Gonza Namulanda*

Centers for Disease Control and Prevention, Atlanta, GA, USA

Objective
This presentation will discuss how the Tracking Network is 

exploring the use of EHR to meet Tracking Network surveillance 
challenges and provide other opportunities to enhance environmental 
public health surveillance

Introduction
The Environmental Public Health Tracking Network (Tracking 

Network) is a national surveillance system that integrates 
environmental hazard, exposure, and health outcome data into one 
system. The Tracking Network launched in July 2009, and has since 
been receiving data from 23 funded state and local health departments, 
and several national partners, e.g., Environmental Protection Agency. 
Despite this success, some challenges exist in obtaining more timely 
and complete data to link risk factors, and assign exposure for health 
outcomes with long latency periods before their detection.

The Health Information Technology for Economic and Clinical 
Health (HITECH) Act (2009) facilitates the adoption of electronic 
health records (EHR) through incentivizing the meaningful use 
of certified EHR Technology. Meaningful use is a set of specific 
objectives and data exchange standards that eligible healthcare 
professionals and hospitals must achieve to qualify for the Centers for 
Medicare and Medicaid Services (CMS) Electronic Health Records 
Incentive Programs. Public health agencies in turn need to have the 
capacity to accept these data in the mandated standard and determine 
the potential and use of this increased data.

This presentation will discuss how the Tracking Network is 
exploring the use of EHR to meet Tracking Network surveillance 
challenges and provide other opportunities to enhance environmental 
public health surveillance. We will also present some results of these 
efforts.

Methods
The Tracking Network initiated an exploratory project with the 

goals of determining: i) the data that the Tracking Network can use 
from EHR; ii) information that can be included in EHR to enhance 
environmental public health surveillance; and iii) potential use of 
Tracking Network data in an EHR e.g., for community health needs 
assessments.

We interviewed eight public health informaticians, public health 
professionals, and disease surveillance experts. We also participated 
in CDC’s EHR initiatives such as CDC and Office of the National 
Coordinator for Health Information Technology’s (ONC) Standards 
and Interoperability (S&I) Framework initiatives namely, Structured 
Data Capture (SDC) whose aim is to define requirements and 
standards to facilitate the collection of supplemental EHR-derived 
data, and Data Access Framework (DAF) whose aim is to facilitate 
the query of aggregate data from EHR.

Results
Through this work, we have been able to prioritize data that the 

Tracking Network could utilize from EHR; identify a list of possible 
partners for a pilot project to further develop and test how these data 
can be reported from an EHR; identify priority supplemental data 

that can be added to EHR to enhance environmental public health 
surveillance; and develop use-cases for the SDC and DAF initiatives.

Conclusions
Electronic health records have the potential to enhance public 

health surveillance by providing more comprehensive, accurate and 
timely data. However several challenges exist such as: policy and data 
privacy issues, and the lack of common data elements among others.

Keywords
Environmental public health tracking; Environmental public health 
surveillance; Electronic health records; Meaningful use

Acknowledgments

We would like to thank the Tracking Program grantees and contractors 
who contributed to this work, all the experts who allowed us to interview 
them, and participants on the S&I framework initiatives.

*Gonza Namulanda

E-mail: fos0@cdc.gov    

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 7(1):e44, 2015