Lazarus Ross, Klompas Michael, Campion Francis X, McNabb Scott J N, Hou Xuanlin, Daniel James, Haney Gillian, DeMaria Alfred, Lenert Leslie, Platt Richard
Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA, USA.
J Am Med Inform Assoc. 2009 Jan-Feb;16(1):18-24. doi: 10.1197/jamia.M2848. Epub 2008 Oct 24.
Health care providers are legally obliged to report cases of specified diseases to public health authorities, but existing manual, provider-initiated reporting systems generally result in incomplete, error-prone, and tardy information flow. Automated laboratory-based reports are more likely accurate and timely, but lack clinical information and treatment details. Here, we describe the Electronic Support for Public Health (ESP) application, a robust, automated, secure, portable public health detection and messaging system for cases of notifiable diseases. The ESP application applies disease specific logic to any complete source of electronic medical data in a fully automated process, and supports an optional case management workflow system for case notification control. All relevant clinical, laboratory and demographic details are securely transferred to the local health authority as an HL7 message. The ESP application has operated continuously in production mode since January 2007, applying rigorously validated case identification logic to ambulatory EMR data from more than 600,000 patients. Source code for this highly interoperable application is freely available under an approved open-source license at http://esphealth.org.
医疗保健提供者在法律上有义务向公共卫生当局报告特定疾病病例，但现有的由提供者发起的手动报告系统通常会导致信息流不完整、容易出错且不及时。基于实验室的自动报告更有可能准确及时，但缺乏临床信息和治疗细节。在此，我们描述了公共卫生电子支持（ESP）应用程序，这是一个强大、自动、安全、便携的公共卫生检测和消息系统，用于报告应通报疾病的病例。ESP应用程序在全自动过程中对任何完整的电子医疗数据源应用特定疾病逻辑，并支持用于病例通知控制的可选病例管理工作流程系统。所有相关的临床、实验室和人口统计学细节都作为HL7消息安全地传输到当地卫生当局。自2007年1月以来，ESP应用程序一直在生产模式下持续运行，将经过严格验证的病例识别逻辑应用于来自超过60万名患者的门诊电子病历数据。这个高度可互操作的应用程序的源代码可在http://esphealth.org上根据批准的开源许可免费获取。
