| Description |
Public health reporting of communicable diseases is critical for the prevention, control, and monitoring of the spread of disease within a population. Information gathered from clinical systems and shared as public health case reports informs and justifies the actions a public health department may take to prevent and/or investigate disease spread within a community. Monitoring and reporting of communicable diseases are also important to gather evidence about how to treat the disease. Reporting to public health agencies is required by law. Traditionally, the reporting of these diseases has largely relied on a manual process in which clinicians' phone or fax information to local health departments. This process is known to be incomplete for various reasons including lack of clinician understanding of reportable diseases, miscommunication of who is responsible for reporting to public health, and difficulty filling out the appropriate report forms. In February 2019, Intermountain Healthcare implemented Electronic Case Reporting (eCR) for the reporting of four reportable conditions as part of the Digital Bridge project (Barnes, et al., 2019). The Digital Bridge project is "a national governance model for systems change, bringing together software vendors, public health, and healthcare" (Cooney, et al. 2018). Electronic Case Reporting is the automated generation and transmission of case reports from electronic health records (EHRs) to Public Health Agencies (PHAs) for review and action. eCR reduces the burden on healthcare providers to accomplish their reporting requirements to public health and improves the timeliness and completeness of case reports at the local, state, and national levels (Association of Public Health Laboratories, 2020). Some important components of eCR are: standard data extraction from EHR's, trigger codes, decision support rules to help decide when to or not to send reportable data and where to send pertinent data, and forms that include additional data that those receiving the reports might find helpful, which ELR lacks (Rennick et al., 2016). Initial implementation of eCR at Intermountain Healthcare was focused on 4 diseases: Chlamydia, Gonorrhea, Pertussis, and Salmonellosis. eCR's are generated based upon clinician documentation, orders, as well as lab results (Barnes, et al. 2019). Even though electronic reporting has been happening in the background, the traditional, clinician-driven manual reporting process is still occurring. Since implementing the limited eCR in February of 2019, there is an opportunity to evaluate and expand the electronic reporting system, with a goal to transition entirely to an electronic reporting system. Serendipitously, as this project was being conceived, the world started experiencing a pandemic due to the coronavirus COVID-19. This particular virus is believed to have originated in Wuhan, Hubei Province, China and has since spread throughout the world causing 131,037 deaths as of April 15, 2020 (World Health Organization, 2020). In response, Intermountain healthcare implemented electronic reporting of COVID-19 infections as well, and additional research questions surfaced. Therefore, the objectives of the research described in this project are to: -Describe current workflow and information flow related to case reporting from Intermountain to Utah public health authorities, and -Evaluate whether data required on the paper COVID-19 surveillance form published by the CDC could be represented in the HL7 V2 standards-based electronic initial case report (eICR) in order to meet public health surveillance needs. |
