Editor's note: For the latest news on coronavirus disease 2019, visit https://www.aappublications.org/news/2020/01/28/coronavirus.
Coronavirus disease 2019 (COVID-19) has been dominating the news. Before that, it was Zika virus. And before that, it was Ebola virus, which is making a comeback.
The sudden appearance of a new viral threat will continue to occur. The world is interconnected, with the globalization of industrial supply chains, tourism and rapid international travel. Therefore, it is inevitable that pediatricians will confront infectious disease crises with some regularity.
Electronic health records (EHRs) are making important contributions to the public health management of these crises.
EHRs support the infrastructure that automates surveillance and reporting of cases of important syndromes to local and state public health agencies and the Centers for Disease Control and Prevention (CDC).
EHRs in many emergency departments (EDs), including pediatric EDs, contribute to the National Syndromic Surveillance Program (NSSP). The NSSP draws from more than 4,000 facilities and covers 70% of the nation’s ED visits in near real time. The CDC defines collection of signs and symptoms that are of interest (e.g., fever and cough). Data on patients who have these signs and symptoms documented are abstracted from EHRs via the CDC’s BioSense Platform, and reports are generated daily.
In addition to the NSSP, the public health community and CDC have initiated a program of automated surveillance for diagnoses of public health interest. The electronic initial case report (eICR) is used to track diseases, like measles or chlamydia, that are reportable by law or regulation. Pediatricians in participating health systems no longer need to locate and complete public health forms when they encounter a reportable case because their EHR handles reporting in the background.
The eICR system also can be used to collect data on emerging threats. When the coronavirus threat emerged, within a few days:
- The CDC published relevant diagnosis codes (ICD-10 and SNOMED).
- EHR vendors “consumed” those codes into their systems overnight.
- Participating health systems began sending relevant case data automatically to public health the next day.
Importantly, the system can automate the delivery of important data back to the reporting clinician, including guidance on current recommendations for the care of patients.
The good news for pediatricians is that all of this occurs without extra effort — the EHR takes care of it in an automated way. This allows pediatricians to prioritize providing support and care to patients and their families as they navigate these events.
The eICR system is not widely distributed yet, but it is hoped that it will become prevalent over the next 12-18 months.
The surveillance and management of infectious disease emergencies like the coronavirus outbreak is one example of health information technology benefiting all concerned.
Dr. Wiesenthal is a member of the AAP Council on Clinical Information Technology Executive Committee and the Section on Infectious Diseases.
