Tapping into electronic health records to improve community health may prove just as accurate—but more efficient—than relying on traditional public health surveys, according to a new study.
The research draws on data from the NYC Macroscope project and demonstrates the promise of EHRs as public health tools.
Lorna Thorpe of the NYU School of Medicine's Department of Population Health and the New York City Department of Health and Mental Hygiene compared the data collected from EHRs with the data from in-person and telephone surveys. For some conditions—hypertension, diabetes, smoking, and obesity—EHR data were as accurate as the data from the more traditional surveys in describing the prevalence of those conditions across a population.
"If it's measured well and captured well in the EHR, such as hypertension, we can extract that data and do appropriate estimation out to the full population," Thorpe said.
For other conditions—high cholesterol, depression, and flu vaccination—the EHRs were less accurate. That may be because people get flu shots from providers other than primary care physicians, for instance, and because some providers don't screen for depression.
The NYC Macroscope pulls EHR primary-care data from patients in New York City, measuring them on such chronic conditions as diabetes, hypertension, and depression. The health surveillance program was launched in 2013 as a public health tool that gives health officials near real-time information on chronic conditions in populations.
Though the NYC Macroscope did not use a representative sample, after statistical weighting techniques to reflect the demographics of the city were applied to the data—which came from more than 700,000 patients—results were comparable in accuracy to those from the NYC Health and Nutrition Examination Survey and the NYC Community Health Survey.
That bodes well for population and public health, Thorpe said. "We're interested in trying to apply our learning from this network of primary care practices to other networks," she said. In the future, she added, EHR networks might be brought together to bring both a broader scope and greater depth to what health officials can look at.
"EHR-based surveillance systems can be cost effective and timely," the authors of the study wrote. "Especially when used in conjunction with other data sources, they can provide a comprehensive and accurate picture of the health of a define population."