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Kraus EM, Saintus L, Martinez AK, Brand B, Begley E, Merritt RK, Hamilton A, Rubin R, Sullivan A, Karras BT, Grannis S, Brooks IM, Mui JY, Carton TW, Hohman KH, Klompas M, Dixon BE. Fostering Governance and Information Partnerships for Chronic Disease Surveillance: The Multi-State EHR-Based Network for Disease Surveillance. J Public Health Manag Pract 2024; 30:244-254. [PMID: 38271106 PMCID: PMC10811406 DOI: 10.1097/phh.0000000000001810] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
CONTEXT Electronic health records (EHRs) are an emerging chronic disease surveillance data source and facilitating this data sharing is complex. PROGRAM Using the experience of the Multi-State EHR-Based Network for Disease Surveillance (MENDS), this article describes implementation of a governance framework that aligns technical, statutory, and organizational requirements to facilitate EHR data sharing for chronic disease surveillance. IMPLEMENTATION MENDS governance was cocreated with data contributors and health departments representing Texas, New Orleans, Louisiana, Chicago, Washington, and Indiana through engagement from 2020 to 2022. MENDS convened a governance body, executed data-sharing agreements, and developed a master governance document to codify policies and procedures. RESULTS The MENDS governance committee meets regularly to develop policies and procedures on data use and access, timeliness and quality, validation, representativeness, analytics, security, small cell suppression, software implementation and maintenance, and privacy. Resultant policies are codified in a master governance document. DISCUSSION The MENDS governance approach resulted in a transparent governance framework that cultivates trust across the network. MENDS's experience highlights the time and resources needed by EHR-based public health surveillance networks to establish effective governance.
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Affiliation(s)
- Emily McCormick Kraus
- The Task Force for Global Health, Public Health Informatics Institute, Decatur, Georgia (Dr Kraus, Ms Saintus, and Mr Brand); Kraushold Consulting, Denver, Colorado (Dr Kraus); National Association of Chronic Disease Directors, Decatur, Georgia (Ms Martinez and Dr Hohman); Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Begley and Mr Merritt); AllianceChicago, Chicago, Illinois (Mr Hamilton); OneHealthPort, Seattle, Washington (Mr Rubin); Washington State Department of Health, Tumwater, Washington (Drs Sullivan and Karras); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Drs Grannis and Dixon); Indiana University School of Medicine, Indianapolis, Indiana (Dr Grannis); Health Data Compass, University of Colorado Anschutz, Aurora, Colorado (Dr Brooks and Ms Mui); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Klompas); and Indiana University Fairbanks School of Public Health, Indianapolis, Indiana (Dr Dixon)
| | - Lina Saintus
- The Task Force for Global Health, Public Health Informatics Institute, Decatur, Georgia (Dr Kraus, Ms Saintus, and Mr Brand); Kraushold Consulting, Denver, Colorado (Dr Kraus); National Association of Chronic Disease Directors, Decatur, Georgia (Ms Martinez and Dr Hohman); Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Begley and Mr Merritt); AllianceChicago, Chicago, Illinois (Mr Hamilton); OneHealthPort, Seattle, Washington (Mr Rubin); Washington State Department of Health, Tumwater, Washington (Drs Sullivan and Karras); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Drs Grannis and Dixon); Indiana University School of Medicine, Indianapolis, Indiana (Dr Grannis); Health Data Compass, University of Colorado Anschutz, Aurora, Colorado (Dr Brooks and Ms Mui); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Klompas); and Indiana University Fairbanks School of Public Health, Indianapolis, Indiana (Dr Dixon)
| | - Amanda K. Martinez
- The Task Force for Global Health, Public Health Informatics Institute, Decatur, Georgia (Dr Kraus, Ms Saintus, and Mr Brand); Kraushold Consulting, Denver, Colorado (Dr Kraus); National Association of Chronic Disease Directors, Decatur, Georgia (Ms Martinez and Dr Hohman); Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Begley and Mr Merritt); AllianceChicago, Chicago, Illinois (Mr Hamilton); OneHealthPort, Seattle, Washington (Mr Rubin); Washington State Department of Health, Tumwater, Washington (Drs Sullivan and Karras); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Drs Grannis and Dixon); Indiana University School of Medicine, Indianapolis, Indiana (Dr Grannis); Health Data Compass, University of Colorado Anschutz, Aurora, Colorado (Dr Brooks and Ms Mui); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Klompas); and Indiana University Fairbanks School of Public Health, Indianapolis, Indiana (Dr Dixon)
| | - Bill Brand
- The Task Force for Global Health, Public Health Informatics Institute, Decatur, Georgia (Dr Kraus, Ms Saintus, and Mr Brand); Kraushold Consulting, Denver, Colorado (Dr Kraus); National Association of Chronic Disease Directors, Decatur, Georgia (Ms Martinez and Dr Hohman); Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Begley and Mr Merritt); AllianceChicago, Chicago, Illinois (Mr Hamilton); OneHealthPort, Seattle, Washington (Mr Rubin); Washington State Department of Health, Tumwater, Washington (Drs Sullivan and Karras); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Drs Grannis and Dixon); Indiana University School of Medicine, Indianapolis, Indiana (Dr Grannis); Health Data Compass, University of Colorado Anschutz, Aurora, Colorado (Dr Brooks and Ms Mui); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Klompas); and Indiana University Fairbanks School of Public Health, Indianapolis, Indiana (Dr Dixon)
| | - Elin Begley
- The Task Force for Global Health, Public Health Informatics Institute, Decatur, Georgia (Dr Kraus, Ms Saintus, and Mr Brand); Kraushold Consulting, Denver, Colorado (Dr Kraus); National Association of Chronic Disease Directors, Decatur, Georgia (Ms Martinez and Dr Hohman); Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Begley and Mr Merritt); AllianceChicago, Chicago, Illinois (Mr Hamilton); OneHealthPort, Seattle, Washington (Mr Rubin); Washington State Department of Health, Tumwater, Washington (Drs Sullivan and Karras); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Drs Grannis and Dixon); Indiana University School of Medicine, Indianapolis, Indiana (Dr Grannis); Health Data Compass, University of Colorado Anschutz, Aurora, Colorado (Dr Brooks and Ms Mui); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Klompas); and Indiana University Fairbanks School of Public Health, Indianapolis, Indiana (Dr Dixon)
| | - Robert K. Merritt
- The Task Force for Global Health, Public Health Informatics Institute, Decatur, Georgia (Dr Kraus, Ms Saintus, and Mr Brand); Kraushold Consulting, Denver, Colorado (Dr Kraus); National Association of Chronic Disease Directors, Decatur, Georgia (Ms Martinez and Dr Hohman); Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Begley and Mr Merritt); AllianceChicago, Chicago, Illinois (Mr Hamilton); OneHealthPort, Seattle, Washington (Mr Rubin); Washington State Department of Health, Tumwater, Washington (Drs Sullivan and Karras); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Drs Grannis and Dixon); Indiana University School of Medicine, Indianapolis, Indiana (Dr Grannis); Health Data Compass, University of Colorado Anschutz, Aurora, Colorado (Dr Brooks and Ms Mui); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Klompas); and Indiana University Fairbanks School of Public Health, Indianapolis, Indiana (Dr Dixon)
| | - Andrew Hamilton
- The Task Force for Global Health, Public Health Informatics Institute, Decatur, Georgia (Dr Kraus, Ms Saintus, and Mr Brand); Kraushold Consulting, Denver, Colorado (Dr Kraus); National Association of Chronic Disease Directors, Decatur, Georgia (Ms Martinez and Dr Hohman); Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Begley and Mr Merritt); AllianceChicago, Chicago, Illinois (Mr Hamilton); OneHealthPort, Seattle, Washington (Mr Rubin); Washington State Department of Health, Tumwater, Washington (Drs Sullivan and Karras); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Drs Grannis and Dixon); Indiana University School of Medicine, Indianapolis, Indiana (Dr Grannis); Health Data Compass, University of Colorado Anschutz, Aurora, Colorado (Dr Brooks and Ms Mui); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Klompas); and Indiana University Fairbanks School of Public Health, Indianapolis, Indiana (Dr Dixon)
| | - Rick Rubin
- The Task Force for Global Health, Public Health Informatics Institute, Decatur, Georgia (Dr Kraus, Ms Saintus, and Mr Brand); Kraushold Consulting, Denver, Colorado (Dr Kraus); National Association of Chronic Disease Directors, Decatur, Georgia (Ms Martinez and Dr Hohman); Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Begley and Mr Merritt); AllianceChicago, Chicago, Illinois (Mr Hamilton); OneHealthPort, Seattle, Washington (Mr Rubin); Washington State Department of Health, Tumwater, Washington (Drs Sullivan and Karras); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Drs Grannis and Dixon); Indiana University School of Medicine, Indianapolis, Indiana (Dr Grannis); Health Data Compass, University of Colorado Anschutz, Aurora, Colorado (Dr Brooks and Ms Mui); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Klompas); and Indiana University Fairbanks School of Public Health, Indianapolis, Indiana (Dr Dixon)
| | - Amy Sullivan
- The Task Force for Global Health, Public Health Informatics Institute, Decatur, Georgia (Dr Kraus, Ms Saintus, and Mr Brand); Kraushold Consulting, Denver, Colorado (Dr Kraus); National Association of Chronic Disease Directors, Decatur, Georgia (Ms Martinez and Dr Hohman); Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Begley and Mr Merritt); AllianceChicago, Chicago, Illinois (Mr Hamilton); OneHealthPort, Seattle, Washington (Mr Rubin); Washington State Department of Health, Tumwater, Washington (Drs Sullivan and Karras); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Drs Grannis and Dixon); Indiana University School of Medicine, Indianapolis, Indiana (Dr Grannis); Health Data Compass, University of Colorado Anschutz, Aurora, Colorado (Dr Brooks and Ms Mui); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Klompas); and Indiana University Fairbanks School of Public Health, Indianapolis, Indiana (Dr Dixon)
| | - Bryant Thomas Karras
- The Task Force for Global Health, Public Health Informatics Institute, Decatur, Georgia (Dr Kraus, Ms Saintus, and Mr Brand); Kraushold Consulting, Denver, Colorado (Dr Kraus); National Association of Chronic Disease Directors, Decatur, Georgia (Ms Martinez and Dr Hohman); Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Begley and Mr Merritt); AllianceChicago, Chicago, Illinois (Mr Hamilton); OneHealthPort, Seattle, Washington (Mr Rubin); Washington State Department of Health, Tumwater, Washington (Drs Sullivan and Karras); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Drs Grannis and Dixon); Indiana University School of Medicine, Indianapolis, Indiana (Dr Grannis); Health Data Compass, University of Colorado Anschutz, Aurora, Colorado (Dr Brooks and Ms Mui); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Klompas); and Indiana University Fairbanks School of Public Health, Indianapolis, Indiana (Dr Dixon)
| | - Shaun Grannis
- The Task Force for Global Health, Public Health Informatics Institute, Decatur, Georgia (Dr Kraus, Ms Saintus, and Mr Brand); Kraushold Consulting, Denver, Colorado (Dr Kraus); National Association of Chronic Disease Directors, Decatur, Georgia (Ms Martinez and Dr Hohman); Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Begley and Mr Merritt); AllianceChicago, Chicago, Illinois (Mr Hamilton); OneHealthPort, Seattle, Washington (Mr Rubin); Washington State Department of Health, Tumwater, Washington (Drs Sullivan and Karras); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Drs Grannis and Dixon); Indiana University School of Medicine, Indianapolis, Indiana (Dr Grannis); Health Data Compass, University of Colorado Anschutz, Aurora, Colorado (Dr Brooks and Ms Mui); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Klompas); and Indiana University Fairbanks School of Public Health, Indianapolis, Indiana (Dr Dixon)
| | - Ian M. Brooks
- The Task Force for Global Health, Public Health Informatics Institute, Decatur, Georgia (Dr Kraus, Ms Saintus, and Mr Brand); Kraushold Consulting, Denver, Colorado (Dr Kraus); National Association of Chronic Disease Directors, Decatur, Georgia (Ms Martinez and Dr Hohman); Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Begley and Mr Merritt); AllianceChicago, Chicago, Illinois (Mr Hamilton); OneHealthPort, Seattle, Washington (Mr Rubin); Washington State Department of Health, Tumwater, Washington (Drs Sullivan and Karras); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Drs Grannis and Dixon); Indiana University School of Medicine, Indianapolis, Indiana (Dr Grannis); Health Data Compass, University of Colorado Anschutz, Aurora, Colorado (Dr Brooks and Ms Mui); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Klompas); and Indiana University Fairbanks School of Public Health, Indianapolis, Indiana (Dr Dixon)
| | - Joyce Y. Mui
- The Task Force for Global Health, Public Health Informatics Institute, Decatur, Georgia (Dr Kraus, Ms Saintus, and Mr Brand); Kraushold Consulting, Denver, Colorado (Dr Kraus); National Association of Chronic Disease Directors, Decatur, Georgia (Ms Martinez and Dr Hohman); Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Begley and Mr Merritt); AllianceChicago, Chicago, Illinois (Mr Hamilton); OneHealthPort, Seattle, Washington (Mr Rubin); Washington State Department of Health, Tumwater, Washington (Drs Sullivan and Karras); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Drs Grannis and Dixon); Indiana University School of Medicine, Indianapolis, Indiana (Dr Grannis); Health Data Compass, University of Colorado Anschutz, Aurora, Colorado (Dr Brooks and Ms Mui); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Klompas); and Indiana University Fairbanks School of Public Health, Indianapolis, Indiana (Dr Dixon)
| | - Thomas W. Carton
- The Task Force for Global Health, Public Health Informatics Institute, Decatur, Georgia (Dr Kraus, Ms Saintus, and Mr Brand); Kraushold Consulting, Denver, Colorado (Dr Kraus); National Association of Chronic Disease Directors, Decatur, Georgia (Ms Martinez and Dr Hohman); Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Begley and Mr Merritt); AllianceChicago, Chicago, Illinois (Mr Hamilton); OneHealthPort, Seattle, Washington (Mr Rubin); Washington State Department of Health, Tumwater, Washington (Drs Sullivan and Karras); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Drs Grannis and Dixon); Indiana University School of Medicine, Indianapolis, Indiana (Dr Grannis); Health Data Compass, University of Colorado Anschutz, Aurora, Colorado (Dr Brooks and Ms Mui); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Klompas); and Indiana University Fairbanks School of Public Health, Indianapolis, Indiana (Dr Dixon)
| | - Katherine H. Hohman
- The Task Force for Global Health, Public Health Informatics Institute, Decatur, Georgia (Dr Kraus, Ms Saintus, and Mr Brand); Kraushold Consulting, Denver, Colorado (Dr Kraus); National Association of Chronic Disease Directors, Decatur, Georgia (Ms Martinez and Dr Hohman); Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Begley and Mr Merritt); AllianceChicago, Chicago, Illinois (Mr Hamilton); OneHealthPort, Seattle, Washington (Mr Rubin); Washington State Department of Health, Tumwater, Washington (Drs Sullivan and Karras); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Drs Grannis and Dixon); Indiana University School of Medicine, Indianapolis, Indiana (Dr Grannis); Health Data Compass, University of Colorado Anschutz, Aurora, Colorado (Dr Brooks and Ms Mui); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Klompas); and Indiana University Fairbanks School of Public Health, Indianapolis, Indiana (Dr Dixon)
| | - Michael Klompas
- The Task Force for Global Health, Public Health Informatics Institute, Decatur, Georgia (Dr Kraus, Ms Saintus, and Mr Brand); Kraushold Consulting, Denver, Colorado (Dr Kraus); National Association of Chronic Disease Directors, Decatur, Georgia (Ms Martinez and Dr Hohman); Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Begley and Mr Merritt); AllianceChicago, Chicago, Illinois (Mr Hamilton); OneHealthPort, Seattle, Washington (Mr Rubin); Washington State Department of Health, Tumwater, Washington (Drs Sullivan and Karras); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Drs Grannis and Dixon); Indiana University School of Medicine, Indianapolis, Indiana (Dr Grannis); Health Data Compass, University of Colorado Anschutz, Aurora, Colorado (Dr Brooks and Ms Mui); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Klompas); and Indiana University Fairbanks School of Public Health, Indianapolis, Indiana (Dr Dixon)
| | - Brian E. Dixon
- The Task Force for Global Health, Public Health Informatics Institute, Decatur, Georgia (Dr Kraus, Ms Saintus, and Mr Brand); Kraushold Consulting, Denver, Colorado (Dr Kraus); National Association of Chronic Disease Directors, Decatur, Georgia (Ms Martinez and Dr Hohman); Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Begley and Mr Merritt); AllianceChicago, Chicago, Illinois (Mr Hamilton); OneHealthPort, Seattle, Washington (Mr Rubin); Washington State Department of Health, Tumwater, Washington (Drs Sullivan and Karras); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis, Indiana (Drs Grannis and Dixon); Indiana University School of Medicine, Indianapolis, Indiana (Dr Grannis); Health Data Compass, University of Colorado Anschutz, Aurora, Colorado (Dr Brooks and Ms Mui); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Dr Klompas); and Indiana University Fairbanks School of Public Health, Indianapolis, Indiana (Dr Dixon)
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Hohman KH, Martinez AK, Klompas M, Kraus EM, Li W, Carton TW, Cocoros NM, Jackson SL, Karras BT, Wiltz JL, Wall HK. Leveraging Electronic Health Record Data for Timely Chronic Disease Surveillance: The Multi-State EHR-Based Network for Disease Surveillance. J Public Health Manag Pract 2023; 29:162-173. [PMID: 36715594 PMCID: PMC9897452 DOI: 10.1097/phh.0000000000001693] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
CONTEXT Electronic health record (EHR) data can potentially make chronic disease surveillance more timely, actionable, and sustainable. Although use of EHR data can address numerous limitations of traditional surveillance methods, timely surveillance data with broad population coverage require scalable systems. This report describes implementation, challenges, and lessons learned from the Multi-State EHR-Based Network for Disease Surveillance (MENDS) to help inform how others work with EHR data to develop distributed networks for surveillance. PROGRAM Funded by the Centers for Disease Control and Prevention (CDC), MENDS is a data modernization demonstration project that aims to develop a timely national chronic disease sentinel surveillance system using EHR data. It facilitates partnerships between data contributors (health information exchanges, other data aggregators) and data users (state and local health departments). MENDS uses query and visualization software to track local emerging trends. The program also uses statistical and geospatial methods to generate prevalence estimates of chronic disease risk measures at the national and local levels. Resulting data products are designed to inform public health practice and improve the health of the population. IMPLEMENTATION MENDS includes 5 partner sites that leverage EHR data from 91 health system and clinic partners and represents approximately 10 million patients across the United States. Key areas of implementation include governance, partnerships, technical infrastructure and support, chronic disease algorithms and validation, weighting and modeling, and workforce education for public health data users. DISCUSSION MENDS presents a scalable distributed network model for implementing national chronic disease surveillance that leverages EHR data. Priorities as MENDS matures include producing prevalence estimates at various geographic and subpopulation levels, developing enhanced data sharing and interoperability capacity using international data standards, scaling the network to improve coverage nationally and among underrepresented geographic areas and subpopulations, and expanding surveillance of additional chronic disease measures and social determinants of health.
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Affiliation(s)
- Katherine H. Hohman
- National Association of Chronic Disease Directors (NACDD), Decatur, Georgia (Dr Hohman); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Drs Klompas and Cocoros); Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts (Dr Li); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Division for Heart Disease and Stroke Prevention (Dr Jackson and Ms Wall) and Office of the Director (Dr Wiltz), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; and Washington State Department of Health, Tumwater, Washington (Dr Karras). Ms Martinez is an independent consultant to NACDD. Dr Kraus is an independent consultant to Public Health Informatics Institute, a program of the Task Force for Global Health
| | - Amanda K. Martinez
- National Association of Chronic Disease Directors (NACDD), Decatur, Georgia (Dr Hohman); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Drs Klompas and Cocoros); Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts (Dr Li); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Division for Heart Disease and Stroke Prevention (Dr Jackson and Ms Wall) and Office of the Director (Dr Wiltz), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; and Washington State Department of Health, Tumwater, Washington (Dr Karras). Ms Martinez is an independent consultant to NACDD. Dr Kraus is an independent consultant to Public Health Informatics Institute, a program of the Task Force for Global Health
| | - Michael Klompas
- National Association of Chronic Disease Directors (NACDD), Decatur, Georgia (Dr Hohman); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Drs Klompas and Cocoros); Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts (Dr Li); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Division for Heart Disease and Stroke Prevention (Dr Jackson and Ms Wall) and Office of the Director (Dr Wiltz), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; and Washington State Department of Health, Tumwater, Washington (Dr Karras). Ms Martinez is an independent consultant to NACDD. Dr Kraus is an independent consultant to Public Health Informatics Institute, a program of the Task Force for Global Health
| | - Emily M. Kraus
- National Association of Chronic Disease Directors (NACDD), Decatur, Georgia (Dr Hohman); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Drs Klompas and Cocoros); Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts (Dr Li); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Division for Heart Disease and Stroke Prevention (Dr Jackson and Ms Wall) and Office of the Director (Dr Wiltz), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; and Washington State Department of Health, Tumwater, Washington (Dr Karras). Ms Martinez is an independent consultant to NACDD. Dr Kraus is an independent consultant to Public Health Informatics Institute, a program of the Task Force for Global Health
| | - Wenjun Li
- National Association of Chronic Disease Directors (NACDD), Decatur, Georgia (Dr Hohman); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Drs Klompas and Cocoros); Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts (Dr Li); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Division for Heart Disease and Stroke Prevention (Dr Jackson and Ms Wall) and Office of the Director (Dr Wiltz), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; and Washington State Department of Health, Tumwater, Washington (Dr Karras). Ms Martinez is an independent consultant to NACDD. Dr Kraus is an independent consultant to Public Health Informatics Institute, a program of the Task Force for Global Health
| | - Thomas W. Carton
- National Association of Chronic Disease Directors (NACDD), Decatur, Georgia (Dr Hohman); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Drs Klompas and Cocoros); Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts (Dr Li); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Division for Heart Disease and Stroke Prevention (Dr Jackson and Ms Wall) and Office of the Director (Dr Wiltz), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; and Washington State Department of Health, Tumwater, Washington (Dr Karras). Ms Martinez is an independent consultant to NACDD. Dr Kraus is an independent consultant to Public Health Informatics Institute, a program of the Task Force for Global Health
| | - Noelle M. Cocoros
- National Association of Chronic Disease Directors (NACDD), Decatur, Georgia (Dr Hohman); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Drs Klompas and Cocoros); Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts (Dr Li); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Division for Heart Disease and Stroke Prevention (Dr Jackson and Ms Wall) and Office of the Director (Dr Wiltz), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; and Washington State Department of Health, Tumwater, Washington (Dr Karras). Ms Martinez is an independent consultant to NACDD. Dr Kraus is an independent consultant to Public Health Informatics Institute, a program of the Task Force for Global Health
| | - Sandra L. Jackson
- National Association of Chronic Disease Directors (NACDD), Decatur, Georgia (Dr Hohman); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Drs Klompas and Cocoros); Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts (Dr Li); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Division for Heart Disease and Stroke Prevention (Dr Jackson and Ms Wall) and Office of the Director (Dr Wiltz), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; and Washington State Department of Health, Tumwater, Washington (Dr Karras). Ms Martinez is an independent consultant to NACDD. Dr Kraus is an independent consultant to Public Health Informatics Institute, a program of the Task Force for Global Health
| | - Bryant Thomas Karras
- National Association of Chronic Disease Directors (NACDD), Decatur, Georgia (Dr Hohman); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Drs Klompas and Cocoros); Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts (Dr Li); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Division for Heart Disease and Stroke Prevention (Dr Jackson and Ms Wall) and Office of the Director (Dr Wiltz), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; and Washington State Department of Health, Tumwater, Washington (Dr Karras). Ms Martinez is an independent consultant to NACDD. Dr Kraus is an independent consultant to Public Health Informatics Institute, a program of the Task Force for Global Health
| | - Jennifer L. Wiltz
- National Association of Chronic Disease Directors (NACDD), Decatur, Georgia (Dr Hohman); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Drs Klompas and Cocoros); Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts (Dr Li); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Division for Heart Disease and Stroke Prevention (Dr Jackson and Ms Wall) and Office of the Director (Dr Wiltz), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; and Washington State Department of Health, Tumwater, Washington (Dr Karras). Ms Martinez is an independent consultant to NACDD. Dr Kraus is an independent consultant to Public Health Informatics Institute, a program of the Task Force for Global Health
| | - Hilary K. Wall
- National Association of Chronic Disease Directors (NACDD), Decatur, Georgia (Dr Hohman); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts (Drs Klompas and Cocoros); Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts (Dr Li); Louisiana Public Health Institute, New Orleans, Louisiana (Dr Carton); Division for Heart Disease and Stroke Prevention (Dr Jackson and Ms Wall) and Office of the Director (Dr Wiltz), National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; and Washington State Department of Health, Tumwater, Washington (Dr Karras). Ms Martinez is an independent consultant to NACDD. Dr Kraus is an independent consultant to Public Health Informatics Institute, a program of the Task Force for Global Health
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