Long term goal: The goal of the proposed public health informatics research project is to implement and? evaluate a model electronic health record (EHR) clinical decision support system based on both clinical? indicators and public health goals. The project is being led by the Institute for Urban Family Health, a? community health center (CHC). Since 2001, the Institute has implemented an EHR at its network of 13 fulltime? ambulatory sites to improve the quality and outcomes of care provided to approximately 70,000 patients? annually. 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 by? enacting three intervention components that: (1) evaluate the utility EHR clinical decision supports for each? of ten Take Care New York (TCNY) public health priority areas; (2) assess the effectiveness of three EHR? clinical decision support """"""""use cases"""""""" that are informed by epidemiological data; and (3) evaluate methods for? automated two-way transfer of data between the citywide immunization and lead registries and an EHR? Rationale: 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 health? value of incorporating epidemiological data and public health priorities into these systems. The researchers? seek to promote sound theory and application of electronic CDSS by integrating demographic? characteristics, pervasive conditions represented by the TCNY goals, and health information with a? traditional clinical knowledge base.? Methods: The proposed study will use a host of research measures, including a series of clinical? intervention metodologies capturing patient and provider adherence, provider surveys, and epidemiological? and clinical inidcators analyses. The protocol will be designed and implemented by project staff in? partnership 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 that? produces, transfers, and applies locally relevant, evidence-based knowledge. Lessons learned will extend? traditional EHR uses, resulting in improved clinical care tools and public health response capability.
