Long term goal: The goal of the proposed public health informatics research project is to implement andevaluate a model electronic health record (EHR) clinical decision support system based on both clinicalindicators and public health goals. The project is being led by the Institute for Urban Family Health, acommunity health center (CHC). Since 2001, the Institute has implemented an EHR at its network of 13 fulltimeambulatory sites to improve the quality and outcomes of care provided to approximately 70,000 patientsannually. It is the first free-standing CHC in New York City - and one of only a few nationally - to do so.
Specific aims : This project will develop and assess the strengths of a model EHR for public health byenacting three intervention components that: (1) evaluate the utility EHR clinical decision supports for eachof ten Take Care New York (TCNY) public health priority areas; (2) assess the effectiveness of three EHRclinical decision support 'use cases' that are informed by epidemiological data; and (3) evaluate methods forautomated two-way transfer of data between the citywide immunization and lead registries and an EHRRationale: A growing body of literature points to the role that clinical decision support systems (CDSS)play in improving patient care and health outcomes, but fails to examine both the clinical and public healthvalue of incorporating epidemiological data and public health priorities into these systems. The researchersseek to promote sound theory and application of electronic CDSS by integrating demographiccharacteristics, pervasive conditions represented by the TCNY goals, and health information with atraditional clinical knowledge base.Methods: The proposed study will use a host of research measures, including a series of clinicalintervention metodologies capturing patient and provider adherence, provider surveys, and epidemiologicaland clinical inidcators analyses. The protocol will be designed and implemented by project staff inpartnership with the New York City Center of Excellence in Public Health Informatics partners.Public Health and Technological Value: The project will develop a model EHR for public health thatproduces, transfers, and applies locally relevant, evidence-based knowledge. Lessons learned will extendtraditional EHR uses, resulting in improved clinical care tools and public health response capability.
| Diamond, Carol C; Mostashari, Farzad; Shirky, Clay (2009) Collecting and sharing data for population health: a new paradigm. Health Aff (Millwood) 28:454-66 |
| Mostashari, Farzad; Tripathi, Micky; Kendall, Mat (2009) A tale of two large community electronic health record extension projects. Health Aff (Millwood) 28:345-56 |
