Use of electronic health records to support a public health response to the COVID-19 pandemic in the United States: a perspective from 15 academic medical centers

Subha Madhavan; Lisa Bastarache; Jeffrey S Brown; Atul J Butte; David A Dorr; Peter J Embi; Charles P Friedman; Kevin B Johnson; Jason H Moore; Isaac S Kohane; Philip R O Payne; Jessica D Tenenbaum; Mark G Weiner; Adam B Wilcox; Lucila Ohno-Machado

doi:10.1093/jamia/ocaa287

Use of electronic health records to support a public health response to the COVID-19 pandemic in the United States: a perspective from 15 academic medical centers

J Am Med Inform Assoc. 2021 Feb 15;28(2):393-401. doi: 10.1093/jamia/ocaa287.

Authors

Subha Madhavan¹, Lisa Bastarache², Jeffrey S Brown³, Atul J Butte⁴, David A Dorr⁵, Peter J Embi⁶, Charles P Friedman⁷, Kevin B Johnson², Jason H Moore⁸, Isaac S Kohane⁹, Philip R O Payne¹⁰, Jessica D Tenenbaum^{11

12}, Mark G Weiner¹³, Adam B Wilcox¹⁴, Lucila Ohno-Machado^{15

16}

Affiliations

¹ Innovation Center for Biomedical Informatics, Georgetown University Medical Center, Washington, DC, USA.
² Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
³ Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts, USA.
⁴ University of California Health System (UC Health), University of California, San Francisco, California, USA.
⁵ Departments of Medical Informatics and Clinical Epidemiology and Medicine, Oregon Health and Science University, Portland, Oregon, USA.
⁶ Indiana University School of Medicine, Regenstrief Institute, Inc, Indianapolis, Indiana, USA.
⁷ Department of Learning Health Sciences, University of Michigan, Ann Arbor, Michigan, USA.
⁸ Institute for Biomedical Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁹ Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA.
¹⁰ Institute for Informatics, Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA.
¹¹ North Carolina Department of Health and Human Services, Raleigh, North Carolina, USA.
¹² Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, USA.
¹³ Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA.
¹⁴ Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, USA.
¹⁵ Department of Biomedical Informatics, University of California San Diego Health, La Jolla, California, USA.
¹⁶ Division of Health Services Research & Development, VA San Diego Healthcare System, San Diego, California, USA.

Abstract

Our goal is to summarize the collective experience of 15 organizations in dealing with uncoordinated efforts that result in unnecessary delays in understanding, predicting, preparing for, containing, and mitigating the COVID-19 pandemic in the US. Response efforts involve the collection and analysis of data corresponding to healthcare organizations, public health departments, socioeconomic indicators, as well as additional signals collected directly from individuals and communities. We focused on electronic health record (EHR) data, since EHRs can be leveraged and scaled to improve clinical care, research, and to inform public health decision-making. We outline the current challenges in the data ecosystem and the technology infrastructure that are relevant to COVID-19, as witnessed in our 15 institutions. The infrastructure includes registries and clinical data networks to support population-level analyses. We propose a specific set of strategic next steps to increase interoperability, overall organization, and efficiencies.

Keywords: covid-19; data network; ehr; policy; public health.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Academic Medical Centers
COVID-19*
Electronic Health Records*
Humans
Information Dissemination*
Information Systems / organization & administration*
Public Health Practice*
Registries
United States

Abstract

Publication types

MeSH terms

Grants and funding