Influenza surveillance using electronic health records in the American Indian and Alaska Native population
Open accessAbstract
OBJECTIVE: Increasing use of electronic health records (EHRs) provides new opportunities for public health surveillance. During the 2009 influenza A (H1N1) virus pandemic, we developed a new EHR-based influenza-like illness (ILI) surveillance system designed to be resource sparing, rapidly scalable, and flexible. 4 weeks after the first pandemic case, ILI data from Indian Health Service (IHS) facilities were being analyzed. MATERIALS AND METHODS: The system defines ILI as a patient visit containing either an influenza-specific International Classification of Disease, V.9 (ICD-9) code or one or more of 24 ILI-related ICD-9 codes plus a documented temperature ≥100°F. EHR-based data are uploaded nightly. To validate results, ILI visits identified by the new system were compared to ILI visits found by medical record review, and the new system's results were compared with those of the traditional US ILI Surveillance Network. RESULTS: The system monitored ILI activity at an average of 60% of the 269 IHS electronic health databases. EHR-based surveillance detected ILI visits with a sensitivity of 96.4% and a specificity of 97.8% based on chart review (N=2375) of visits at two facilities in September 2009. At the peak of the pandemic (week 41, October 17, 2009), the median time from an ILI visit to data transmission was 6 days, with a mode of 1 day. DISCUSSION: EHR-based ILI surveillance was accurate, timely, occurred at the majority of IHS facilities nationwide, and provided useful information for decision makers. EHRs thus offer the opportunity to transform public health surveillance.
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Data accuracy collected through EHR ranges between 44% to 100%.
“According to the study presented in [87], data accuracy collected through EHR ranges between 44% to 100%.”
From Secondary Use of Electronic Health Record: Opportunities and Challenges (2020) · cites this paper as [87]
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Pandemic Influenza Preparedness and Vulnerable Populations in Tribal Communities
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Kruse, C. S., Stein, A., Thomas, H., & Kaur, H. (2018) · Journal of Medical Systems · doi:10.1007/s10916-018-1075-6 · Cited by 403 · see citing works
Secondary Use of Electronic Health Record: Opportunities and Challenges
Shah, S. M., & Khan, R. A. (2020) · IEEE Access · doi:10.1109/access.2020.3011099 · Cited by 158 · see citing works
- Authors
- Keck, J. W., Redd, J. T., Cheek, J. E., Layne, L. J., Groom, A. V., Kitka, S., Bruce, M. G., Suryaprasad, A., Amerson, N. L., Cullen, T., Bryan, R. T., & Hennessy, T. W.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Indian Health Service (US)
- Corresponding author
- Redd, John T
- Venue
- Journal of the American Medical Informatics Association
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-01
- Volume
- 21
- Issue
- 1
- Pages
- 132-138
- ISSN
- 1067-5027 (ISSN-L)
- 1527-974X
- PMC
- PMC3912730
- OpenAlex
- W163724755
- Cited by
- 20
- References
- 10
- Citations by year
- 2025: 3 · 2024: 1 · 2022: 1 · 2021: 3 · 2020: 1 · 2018: 1 · 2017: 2 · 2016: 1 · 2015: 1 · 2014: 4 · 2013: 2
- FWCI
- 1.94
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Medical Informatics Association (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Health and Human Services
- Centers for Disease Control and Prevention
- Topics
- Health Sciences › Medicine › Epidemiology › Data-Driven Disease Surveillance
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Keywords
- influenza surveillance, influenza-like illness, electronic health records, 2009 H1N1 pandemic, American Indian and Alaska Native populations, Indian Health Service, ICD-9 codes, data timeliness, disease surveillance
- MeSH terms
- Inuit, Humans, Indians, North American, Influenza, Human, United States, Influenza A Virus, H1N1 Subtype, Electronic Health Records, Pandemics, Public Health Surveillance
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