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Am J Public Health. 2012 May;102(5):e1-4. doi: 10.2105/AJPH.2011.300640. Epub 2012 Mar 15.

How the continuity of care document can advance medical research and public health.

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  • 1School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, USA. john.d.damore@uth.tmc


Electronic health records in the United States currently isolate digital information in proprietary, institutional databases. Experts have identified inadequate data exchange as a leading challenge to advancements in care quality and efficiency. Recent federal health information technology incentives adopt an extensible standard, called the Continuity of Care Document (CCD), as a new basis for digital interoperability. Although this instrument was designed for individual provider communications, the CCD can be effectively reused for population-based research and public health. Three examples in this commentary demonstrate the potential of CCD aggregation and highlight required changes to existing public health and research practices. Transitioning to the use of this new interoperability standard should be a priority for public health investment, research, and development.

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