A new study led by Dr. Brian Dixon, associate professor and director of public health informatics at the IU Richard M. Fairbanks School of Public Health, found that outbreak detection and disease control may be improved by simplified, semi-automated reporting of notifiable diseases to public health authorities (PHA).
The objective of the study was to determine if electronic, pre-populated notifiable disease report forms would have an impact on case reporting rates, the completeness of data in submitted case reports, and the timeliness of case reports by ambulatory care clinics to a PHA – making this the first trial of its kind.
Researchers conducted a two-year, controlled before-and-after trial of a health information exchange (HIE) intervention in Indiana designed to pre-populate notifiable disease reporting forms to providers.
They analyzed data collected from electronic pre-populated reports and “usual care” (paper, fax) reports submitted to a local health department for seven conditions by using a difference-in-differences model. The seven conditions consisted of diseases commonly investigated by local PHA staff members in Indiana — chlamydia, gonorrhea, hepatitis B, hepatitis C, histoplasmosis, salmonellosis, and syphilis. As in most states, providers and laboratories in Indiana are required to report each notifiable disease case they encounter.
Results from the study show that the pre-populated forms, integrated into providers’ workflow and enabled by a health information exchange (HIE) network, not only had a meaningful impact on reporting rates and completeness, but also minimized provider burden. From the participating clinics, 75% of submitted reports were the pre-populated forms generated by the intervention, demonstrating clinics are willing to use the tool to improve their reporting of notifiable conditions.
Having complete, timely information is critical to the work of public health. Identifying and correcting incomplete information can lead to time-consuming and complex medical records review processes that are burdensome and costly for both clinical and public health organizations. Better integration of clinical and public health information systems help to refine technical and workflow processes that can ultimately make public health surveillance more efficient.
The study was conducted in partnership with the Regenstrief Institute and the Indiana Health Information Exchange (IHIE), non-profit community partners that regularly work with faculty at the Fairbanks School of Public Health. Regenstrief is a local, national and global leader in health services research dedicated to a world where better information empowers people to end disease and realize true health. The Indiana Health Information Exchange is a community-based organization that enables hospitals, physicians, laboratories, payers, and other health service providers to avoid redundancy and deliver faster, more efficient, higher quality healthcare to patients in Indiana.
The full study, “Improving Notifiable Disease Case Reporting Through Electronic Information Exchange–Facilitated Decision Support: A Controlled Before-and-After Trial,” is published in the May/June issue of Public Health Reports.
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