Improving Notifiable Disease Case Reporting Through Electronic Information Exchange–Facilitated Decision Support: A Controlled Before-and-After Trial
Open accessAbstract
Objective: Outbreak detection and disease control may be improved by simplified, semi-automated reporting of notifiable diseases to public health authorities. The objective of this study was to determine the effect of an electronic, prepopulated notifiable disease report form on case reporting rates by ambulatory care clinics to public health authorities. Methods: We conducted a 2-year (2012-2014) controlled before-and-after trial of a health information exchange (HIE) intervention in Indiana designed to prepopulate notifiable disease reporting forms to providers. We analyzed data collected from electronic prepopulated reports and “usual care” (paper, fax) reports submitted to a local health department for 7 conditions by using a difference-in-differences model. Primary outcomes were changes in reporting rates, completeness, and timeliness between intervention and control clinics. Results: Provider reporting rates for chlamydia and gonorrhea in intervention clinics increased significantly from 56.9% and 55.6%, respectively, during the baseline period (2012) to 66.4% and 58.3%, respectively, during the intervention period (2013-2014); they decreased from 28.8% and 27.5%, respectively, to 21.7% and 20.6%, respectively, in control clinics ( P < .001). Completeness improved from baseline to intervention for 4 of 15 fields in reports from intervention clinics ( P < .001), although mean completeness improved for 11 fields in both intervention and control clinics. Timeliness improved for both intervention and control clinics; however, reports from control clinics were timelier (mean, 7.9 days) than reports from intervention clinics (mean, 9.7 days). Conclusions: Electronic, prepopulated case reporting forms integrated into providers’ workflow, enabled by an HIE network, can be effective in increasing notifiable disease reporting rates and completeness of information. However, it was difficult to assess the effect of using the forms for diseases with low prevalence (eg, salmonellosis, histoplasmosis).
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ELR provides a robust foundation upon which HIEs can offer electronic case reporting (eCR).
“Moreover, ELR provides a robust foundation upon which HIEs can offer electronic case reporting (eCR) [24].”
From Evolution of clinical Health Information Exchanges to population health resources: a case study of the Indiana network for patient care (2025) · cites this paper as [24]
The Methods (page unavailable) describe electronic laboratory results triggering an HIE system that generates and electronically delivers prepopulated case-reporting forms. This supports laboratory reporting as a basis for HIE-facilitated reporting, but the forms were usually submitted to the health department by fax; the trial does not establish fully electronic case reporting. (LLM, conf=0.84)
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- Authors
- Dixon, B. E., Zhang, Z., Arno, J. N., Revere, D., Joseph Gibson, P., & Grannis, S. J.
- Affiliations
- Regenstrief Institute (US)
- Marion County Public Health Department (US)
- School of Public Health, University of Washington, Seattle, WA, USA
- Marion County Public Health Department, Indianapolis, IN, USA
- Corresponding author
- Dixon, Brian E.
- Venue
- Public Health Reports®
- Publisher
- SAGE Publications
- Published
- 2020-04-06
- Volume
- 135
- Issue
- 3
- Pages
- 401-410
- ISSN
- 0033-3549 (ISSN-L)
- 1468-2877
- PMC
- PMC7238703
- OpenAlex
- W3014454724
- Cited by
- 14
- References
- 38
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 2
- FWCI
- 1.54
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Public Health Reports (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Funders
- Agency for Healthcare Research and Quality (R01HS020909)
- Robert Wood Johnson Foundation (71596)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Medicine › Epidemiology › Data-Driven Disease Surveillance
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Keywords
- communicable disease reporting, health information exchange, clinical decision support, ambulatory care clinics, chlamydia, gonorrhea, reporting rates, reporting completeness, report timeliness, disease surveillance, workflow integration
- MeSH terms
- Ambulatory Care Facilities, Data Collection, Humans, Indiana, Population Surveillance, Socioeconomic Factors, Disease Notification, Electronic Health Records, Controlled Before-After Studies, Health Information Exchange
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