Institute for Family Health, New York, NY 10032, USA.
J Am Med Inform Assoc. 2010 Mar-Apr;17(2):217-9. doi: 10.1136/jamia.2009.000539.
Alerting providers to public health situations requires timeliness and context-relevance, both lacking in current systems. Incorporating decision support tools into electronic health records may provide a way to deploy public health alerts to clinicians at the point of care. A timely process for responding to Health Alert Network messages sent by the New York City Department of Health and Mental Hygiene was developed by a network of community health centers. Alerts with order sets and recommended actions were created to notify primary care providers of local disease outbreaks. The process, effect, and lessons learned from alerts for Legionella, toxogenic E coli, and measles outbreaks are described. Electronic alerts have the potential to improve management of diseases during an outbreak, including appropriate laboratory testing, management guidance, and diagnostic assistance as well as to enhance bi-directional data exchange between clinical and public health organizations.
向医疗服务提供者发出公共卫生警报需要及时性和相关性，而当前的系统在这两方面都有所欠缺。将决策支持工具纳入电子健康记录可能为在护理点向临床医生部署公共卫生警报提供一种方法。一个由社区卫生中心组成的网络制定了及时应对纽约市卫生局发送的“健康警报网络”消息的流程。创建了带有医嘱集和推荐操作的警报，以通知初级保健提供者本地疾病暴发的情况。本文描述了军团菌病、产毒性大肠杆菌和麻疹暴发警报的流程、效果和经验教训。电子警报有可能改善暴发期间疾病的管理，包括适当的实验室检测、管理指导和诊断协助，以及增强临床和公共卫生组织之间的双向数据交换。
