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电子病例报告(eCR)在 COVID-19 公共卫生领域的应用:明尼苏达州卫生部的实施观点。

Electronic case reporting (eCR) of COVID-19 to public health: implementation perspectives from the Minnesota Department of Health.

机构信息

Informatics Program, School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA.

Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA.

出版信息

J Am Med Inform Assoc. 2022 Oct 7;29(11):1958-1966. doi: 10.1093/jamia/ocac133.

Abstract

Electronic case reporting (eCR) is the automated generation and transmission of case reports from electronic health records to public health for review and action. These reports (electronic initial case reports: eICRs) adhere to recommended exchange and terminology standards. eCR is a partnership of the Centers for Disease Control and Prevention (CDC), Association of Public Health Laboratories (APHL) and Council of State and Territorial Epidemiologists (CSTE). The Minnesota Department of Health (MDH) received eICRs for COVID-19 from April 2020 (3 sites, manual process), automated eCR implementation in August 2020 (7 sites), and on-boarded ∼1780 clinical units in 460 sites across 6 integrated healthcare systems (through March 2022). Approximately 20 000 eICRs/month were reported to MDH during high-volume timeframes. With increasing provider/health system implementation, the proportion of COVID-19 cases with an eICR increased to 30% (March 2022). Evaluation of data quality for select demographic variables (gender, race, ethnicity, email, phone, language) across the 6 reporting health systems revealed a high proportion of completeness (>80%) for half of variables and less complete data for rest (ethnicity, email, language) along with low ethnicity data (<50%) for one health system. Presently eCR implementation at MDH includes only one EHR vendor. Next steps will focus on onboarding other EHRs, additional eICR data extraction/utilization, detailed analysis, outreach to address data quality issues, and expanding to other reportable conditions.

摘要

电子病例报告(eCR)是指从电子健康记录中自动生成和传输病例报告,以供公共卫生部门审查和采取行动。这些报告(电子初始病例报告:eICRs)符合推荐的交换和术语标准。eCR 是疾病控制与预防中心(CDC)、公共卫生实验室协会(APHL)和州及地区流行病学家协会(CSTE)的合作伙伴关系。明尼苏达州卫生部(MDH)从 2020 年 4 月开始接收 COVID-19 的 eICR(3 个地点,手动处理),2020 年 8 月实现自动 eCR(7 个地点),并在 6 个综合医疗系统的 460 个地点的约 1780 个临床单位(截至 2022 年 3 月)上线。在高流量时段,每月向 MDH 报告约 20000 份 eICR。随着提供者/医疗系统实施的增加,有 eICR 的 COVID-19 病例比例增加到 30%(2022 年 3 月)。对 6 个报告卫生系统中部分人口统计学变量(性别、种族、民族、电子邮件、电话、语言)的数据质量进行评估,结果发现一半变量的完整性比例较高(>80%),其余变量的数据完整性较低(种族、电子邮件、语言),并且一个卫生系统的种族数据较低(<50%)。目前,MDH 的 eCR 实施仅包括一个 EHR 供应商。下一步将侧重于上线其他 EHR、提取/利用更多 eICR 数据、进行详细分析、开展外联活动以解决数据质量问题,并扩大到其他可报告的疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c0c/9551707/be744e3fb228/ocac133f1.jpg

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