Can EHRs replace surveys for disease surveillance?

An EHR-based surveillance system may help city officials better understand the health of their population, according to an article in American Journal of Public Health.

A research team of epidemiologists, health IT experts and clinicians led by NYC Department of Health and Mental Hygiene and NYU School of Medicine in New York City developed NYC Macroscope, a surveillance system that aggregates data from EHRs representing more than 700,000 primary care patients in the city. The researchers used this system to surveil chronic health conditions.

The researchers compared findings with two surveys — NYC Health and Nutrition Examination Survey and NYC Community Health Survey — from the same year. They found EHR surveillance was as accurate as in-person and telephone surveys for measuring chronic diseases, such as diabetes, hypertension, smoking and obesity. However, depression and influenza vaccination estimates based on EHRs were lower than survey estimates.

The research team concluded EHR-based surveillance systems can complement existing public health tools, like surveys and death records.

"While indicator performance was variable, findings here confirm that a carefully constructed EHR-based surveillance system can generate prevalence estimates comparable to those from gold-standard examination surveys for certain conditions and risk factors," the authors wrote.

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