Oklahoma State Department of Health, Acute Disease Service, Oklahoma City, OK ; Centers for Disease Control and Prevention, Epidemic Intelligence Service, Atlanta, GA ; Current affiliation: Duke University Medical Center, Division of Infectious Diseases, Durham, NC.
Oklahoma State Department of Health, Acute Disease Service, Oklahoma City, OK.
Public Health Rep. 2014 May;129(3):261-6. doi: 10.1177/003335491412900308.
The Health Information Technology for Economic and Clinical Health (HITECH) Act encourages the meaningful use of certified electronic health record technology. A HITECH-compliant core component is nationwide electronic laboratory reporting (ELR) implementation for communicable disease surveillance. In Oklahoma, laboratories with ≥400 positive tests/year for reportable diseases must use ELR. Of 18 such laboratories, two have adopted ELR. We compared completeness and timeliness of ELR reports from these two laboratories with conventional reports from all other Oklahoma laboratories.
We retrospectively reviewed confirmed reportable disease cases for January 1-December 31, 2011, excluding tuberculosis, hepatitis, sexually transmitted infections, diseases without laboratory diagnoses, and immediately reportable diseases. Probable reportable tickborne disease cases were included. We compared ELR with conventional reporting (i.e., mail, fax, telephone, and Internet). We assessed data completeness based on eight demographic and two laboratory fields in each disease report and timeliness by percentage of cases reported in ≤1 business day.
Overall, 1,867 reports met the inclusion criteria; 24% of these reports had been submitted by ELR. Data completeness was 90% for ELR and 95% for conventional reporting. Patient addresses accounted for 97% of the missing data fields for ELR reports. Timeliness was 91% for ELR and 87% for conventional reports.
Although early in the transition to ELR compliance in Oklahoma, ELR has already yielded improved timeliness for communicable disease surveillance. However, ELR did not yield more complete reports than conventional reporting. Requiring specific demographic data fields for ELR reports can improve the completeness of ELR.
健康信息技术促进经济和临床健康（HITECH）法案鼓励对经过认证的电子健康记录技术进行有意义的使用。符合 HITECH 标准的核心组成部分是全国范围内电子实验室报告（ELR）的传染病监测实施。在俄克拉荷马州，每年有≥400 例报告疾病阳性检测的实验室必须使用 ELR。在 18 个这样的实验室中，有两个已经采用了 ELR。我们比较了这两个实验室的 ELR 报告的完整性和及时性与所有其他俄克拉荷马州实验室的常规报告。
我们回顾性地审查了 2011 年 1 月 1 日至 12 月 31 日确诊的传染病报告病例，不包括结核病、肝炎、性传播感染、无实验室诊断的疾病和立即报告的疾病。包括可能报告的蜱传疾病病例。我们比较了 ELR 与常规报告（即邮件、传真、电话和互联网）。我们根据每个疾病报告的八个人口统计学和两个实验室字段评估数据完整性，并根据在≤1 个工作日内报告的病例百分比评估及时性。
总体而言，有 1867 份报告符合纳入标准；其中 24%的报告是通过 ELR 提交的。ELR 的数据完整性为 90%，常规报告为 95%。患者地址占 ELR 报告缺失数据字段的 97%。ELR 的及时性为 91%，常规报告为 87%。
尽管俄克拉荷马州在过渡到 ELR 合规方面还处于早期阶段，但 ELR 已经提高了传染病监测的及时性。然而，ELR 并没有比常规报告产生更完整的报告。为 ELR 报告要求特定的人口统计学数据字段可以提高 ELR 的完整性。
