title: The state of population health surveillance using electronic health records: a narrative review.
abstract: Electronic health records (EHRs) are transforming the practice of clinical medicine, but the extent to which they are being harnessed to advance public health goals remains uncertain. Data extracted from integrated EHR networks offer the potential for almost real-time determination of the health status of populations in care, for targeting interventions to vulnerable populations, and for monitoring the impact of such initiatives over time. This is especially true in ambulatory care settings, which are uniquely suited for monitoring population health indicators including risk factors and disease management indicators associated with chronic diseases. As efforts gather steam to integrate health data across delivery systems, large networks of electronic patient information are increasingly emerging. Few of the national population health surveillance systems that rely on EHR data have progressed beyond laying groundwork to launch and maintain EHR-based surveillance, but a limited number of more focused or local efforts have demonstrated innovation in population health surveillance. Common challenges include incompleteness of population coverage, lack of interoperability across data systems, and variable data quality. This review defines progress, opportunities, and challenges in using EHR data for population health surveillance.
authors.affiliation: 1Department of Population Health, New York University School of Medicine, New York, New York.
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Paul
authors.affiliation: 2Division of Epidemiology, New York City Department of Health and Mental Hygiene, Long Island City, New York.
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Greene
authors.affiliation: 3Division of Health Care Access and Improvement, New York City Department of Health and Mental Hygiene, Primary Care Information Project, Long Island City, New York.
authors.forename: Remle
authors.initials: R
authors.lastname: Newton-Dame
authors.affiliation: 4Epidemiology and Biostatistics Program, CUNY School of Public Health at Hunter College, New York, New York.
authors.forename: Lorna E
authors.initials: LE
authors.lastname: Thorpe
authors.affiliation: 2Division of Epidemiology, New York City Department of Health and Mental Hygiene, Long Island City, New York.
authors.forename: Sharon E
authors.initials: SE
authors.lastname: Perlman
authors.affiliation: 5Special Projects Unit, Bureau of Epidemiology Services, New York City Department of Health and Mental Hygiene, Long Island City, New York.
authors.forename: Katherine H
authors.initials: KH
authors.lastname: McVeigh
authors.affiliation: 1Department of Population Health, New York University School of Medicine, New York, New York.
authors.forename: Marc N
authors.initials: MN
authors.lastname: Gourevitch
mesh_terms: D000553:Ambulatory Care; D002908:Chronic Disease; D019468:Disease Management; D057286:Electronic Health Records / Q000331:legislation & jurisprudence; D020408:Health Insurance Portability and Accountability Act; D006305:Health Status Indicators; D006801:Humans; D007883:Legislation, Medical; D011159:Population Surveillance / Q000379:methods*; D014481:United States