Public health surveillance is the cornerstone of all public health activities, and essential public health? services include monitoring health status to identify and solve community health problems, and diagnosing? and investigating health problems in the community. Progress towards interoperable electronic health? records and regional health information exchange initiatives offers the promise of much higher quality clinical? data for surveillance purposes.? Our overall goal is to develop and demonstrate electronic health information exchange from clinical? information systems that improves public health surveillance of emerging health issues.? We plan to test the following hypotheses:? (1) Routine reporting of antibiotic resistance data through the Electronic Clinical Laboratory Reporting? infrastructure is feasible, acceptable, and useful for public health surveillance. To test this hypothesis, we? plan to initiate secure, standards-based electronic reporting of antibiotic resistance testing data from multiple? clinical laboratories within NYC and to create community-wide outpatient antibiograms.? (2) Electronic health records contain structured and unstructured data that can provide specific, actionable? information for real-time public health surveillance purposes. To test this hypotheses, we plan to examine the? performance characteristics of ambulatory electronic health record (EHR) data elements for syndromic case? and outbreak detection, employing natural language processing for the unstructured elements.
