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Announcements



1. Behavioral Health Clinical Quality Measures (BH CQM) Initiatives – ONC/SAMHSA Webinar
   Thursday, September 27, 2012 at 11:00 A.M. EDT
   The Office of the National Coordinator for Health Information Technology (ONC) and the Substance Abuse and Mental Health Services Administration (SAMHSA) will jointly host a webinar for the behavioral health community this Thursday, September 27, 2012, at 11:00 AM ET. The purpose of the webinar is to broaden awareness about recent efforts to develop, recommend, and incorporate behavioral health clinical quality measures into national health IT initiatives. The webinar will feature speakers from the Centers for Medicare & Medicaid Services and the National Quality Forum, along with the ONC and SAMSHA. They will be presenting recent BH CQM activities, recommendations, and references. To attend the webinar visit https://hhsonc.webex.com/hhsonc/mc. Use phone number +1-408-600-3600, access code 993 620 011, meeting password ONCtep12.

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Public Health Surveillance



1. Two-thirds of states satisfied with ArboNET
   "tate health department perceived utility of and satisfaction with ArboNET, the U.S. National Arboviral Surveillance System"
   Public Health Reports

   August 2012

   N Lindsey and others
   http://www.publichealthreports.org/issueopen.cfm?articleID=2875
   When the West Nile virus appeared in the United States in 1999, CDC began working to establish ArboNET, the national arboviral surveillance system. The new system enabled public health to track the progression of the virus and better understand its epidemiology, ecology, and transmission. Fifty states and three local/territorial health departments are now contributing data. The data are reviewed, summarized, and then distributed via Epi-X, MMWR, CDC websites, the Public Health Agency of Canada, and the U.S. Geological Survey. The authors used an online assessment tool to gauge reporting jurisdictions’ satisfaction with ArboNET’s performance. Two-thirds of respondents were satisfied with ArboNET’s overall performance, although not all users agreed about the usefulness of avian mortality and sentinel animal surveillance. (RJ)
2. Creating a framework to organize surveillance information on climate and public health
   "How can a climate change perspective be integrated into public health surveillance?"
   Public Health

   August 2012

   M Pascal and others
   http://www.sciencedirect.com/science/article/pii/S0033350612001527
   Researchers from the French Institute of Public Health (InVS) propose a method to raise awareness about climate change in the public health community, to identify possible health risks, and to assess the needs for surveillance systems. Despite the growing awareness of the public health effects of climate change in France, the public health surveillance sector has had very little involvement in the drafting of plans to adapt to changes. The paper describes how the Institute set up a working group of French surveillance experts in environmental health, chronic diseases, and infectious diseases to agree on public health objectives and propose a framework that could be used to identify health risks in France, and organize available information. In their conclusion, the authors state, "The majority of the risks identified are already monitored by existing environmental and/or health surveillance systems in France. A general conclusion of all those involved was the need for better integration between environmental and health databases. Interdisciplinarity was also suggested as it is needed, for example, to improve the collection of environmental data representative of exposure to health risks (e.g. environment-based disciplines), and to understand the role of behavioral patterns in exposure (e.g. social scientists)." (FS)
3. Detecting acute HIV infection as part of routine surveillance
   "Integrating acute HIV Infection within routine public health surveillance practices in New York City"
   Public Health Reports

   August 2012

   S Bodach and others
   http://www.publichealthreports.org/issueopen.cfm?articleID=2882
   In this article, researchers from the New York City Department of Health and Mental Hygiene describe two years' experience implementing a program to better detect individuals with acute HIV infection (AHI). The acute phase of HIV infection often is never detected because it is a mild and brief clinical illness and it occurs prior to the production of detectable HIV antibodies. But it is an important phase of HIV infection from the public health perspective. Many screening efforts have been invented involving complex and expensive laboratory procedures. In 2009, FDA approved a fourth-generation antigen/antibody test to make screening more efficient and less expensive. Through CDC, several cities are now evaluating the new test. Starting in 2008, the NYC department made detection of AHI part of routine HIV/AIDS surveillance. Through September 2010, the department conducted 33,027 field investigations to ascertain AHI. Researchers identified six conditions as key to the successful implementation of AHI surveillance, of which two were the availability of electronic laboratory reporting for more timely report and ease of processing the high volume of reportable results, and sophisticated information technology and analytic infrastructure, especially skilled data management and programming staff. (FS)
4. Evaluating surveillance in Brazil
   "Evaluation of Brazil's public health surveillance system within the context of the International Health Regulations (2005)"
   Revista Panamericana de Salud Pública

   August 2012

   MG Teixeira and others
   http://www.scielosp.org/pdf/rpsp/v32n1/v32n1a08.pdf
   This article from Brazil describes an evaluation of the country's public health surveillance system during 2008—2009 in regard to the International Health Regulations 2005. A semi-structured questionnaire was used to collect data from national, state, and municipal health officials. "The results of this study," the authors state, "showed that, in general, the core capacities of the Brazilian [system] have been well established and the system is in compliance with most of the IHR 2005 requisites, particularly at the national and state level." The authors conclude that the system has a well-established legal framework, including the essential technical regulations, and it has the infrastructure, supplies, materials, and mechanisms required for liaison and coordination. But the system still has some weaknesses at the state level, especially in land border areas and small towns. "Professionals in the field need to be more familiar with the IHR 2005 Annex 2 decision tool (designed to increase sensitivity and consistency in the notification process). At the state and municipal level, the capacity to detect, assess, and notify is better than the capacity to investigate, intervene, and communicate. Surveillance activities are conducted 24 hours a day, 7 days a week in 40.7% of states and 35.5% of municipalities. There are shortcomings in organizational activities and methods, and in the process of hiring and training personnel." (FS)

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Public Health Informatics



1. Privacy in an EHR world
   "Test highlights how to do EHR data sharing right"
   
   HealthcareITNews.com

   September 19, 2012

   M Mosquera
   http://www.healthcareitnews.com/news/test-highlights-how-do-ehr-data-sharing-right
   When information is available to providers from an electronic health record and they are able to make more informed decisions based on a comprehensive availability of patient level data – it can have positive impacts on quality, safety, and efficiency. But there may be challenges with respect to privacy when certain elements of the EHR are available without the consent of the patient. The Department of Veterans Affairs  and the Substance Abuse and Mental Health Services Administration have demonstrated how to securely share sensitive health information via electronic health records  (EHRs), according to a September 17 announcement by the Department of Health and Human Services. In particular, a test conducted by those agencies has shown “how substance abuse and other sensitive data can be tagged so that when it is sent in a summary of care record to another provider with the patient’s permission, the receiving provider will know  they need to obtain the patient’s authorization to further disclose the sensitive information with others.” This test is significant because it establishes the capacity for EHR data to exchange with providers, while certain elements are protected from general view. (RJ)
2. A new repository of medical informatics resources
   "e-MIR2: a public online inventory of medical informatics resources"
   
   BMC Medical Informatics & Decision Making

   August 2012

   G de la Calle and others
   http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3441434/
   These authors, from Spain and the United States, report creating eMIR2, a new repository of medical informatics resources from the scientific literature, including architectures or development methodologies, terminologies, vocabularies, databases, and tools. They extracted information about the items automatically from manuscripts published in the top-ranked medical informatics journals using text mining and natural language techniques. The repository was developed to assist researchers in locating and accessing information resources. eMIR2 currently contains 609 resources and is located at http://www.gib.fi.upm.es/eMIR2. Users are routinely solicited for comments about improving the repository and can provide updates to the larger community when new content is available. (RJ)
3. Surveillance and the EMR
   "Integrating clinical practice and public health surveillance using electronic medical record systems"
   
   American Journal of Preventive Medicine

   June 2012

   M Klompas and others
   http://www.sciencedirect.com/science/article/pii/S0749379712002498
   Electronic medical record systems have the potential to improve the relationship between primary care physician and the public health system at the point of care. These authors from Massachusetts describe a surveillance system, Electronic Medical Record Support for Public Health (ESP), that can analyze data captured at the point of care, operate in the background on proprietary data feeds, and send messages to public health. The system was developed by the Harvard Center of Excellence in Public Health Informatics and the Massachusetts Department of Health, with funding from CDC. The code is freely available at esphealth.org. The system serves the provider community by shifting the burden of disease reporting from the clinician to the information system, thereby eliminating the need to sift through raw data to meet the statutory requirements of disease reporting. ESP systems currently are operating in Massachusetts and Ohio. (RJ)
4. Heads up from the ER: Using “biopsy” of an admitted patient’s chart
   "Chart biopsy: an emerging medical practice enabled by electronic health records and its impacts on emergency department–inpatient admission handoffs "
   
   Journal of American Medical Informatics

   September 2012

   B Hilligoss and others
   http://jamia.bmj.com/content/early/2012/09/12/amiajnl-2012-001065.abstract
   The authors, from Ohio State University, conducted an ethnographic study to see how clinicians on the receiving end of an admissions handoff use the electronic health record to prepare for the handoff, a procedure sometimes called a pre-handoff “chart biopsy.” They used semi-structured interviews, observations, and recording of handoff conversations. “ The research found that, when physicians begin the practice of reviewing the EHR, they become active participants in the ‘hand-off’ from the emergency department and can become more effective in the planning of care for the patient. “Chart biopsy has the potential to enrich collaboration and to enable the hospital to act safely, efficiently, and effectively.” (RJ)

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Briefly Noted



1. Smartphones serve health informatics
   "Smartphone as a personal, pervasive health informatics services platform: literature review"
   
   International Medical Informatics Yearbook 2012

   September 2012

   K Wac
   http://www.schattauer.de/en/magazine/subject-areas/journals-a-z/imia-yearbook/imia-yearbook 2012/issue/special/manuscript/17948.html
2. Personal health informatics & Clinical informatics
   "Critical advances in bridging personal health informatics and clinical informatics"
   
   International Medical Informatics Yearbook 2012

   September 2012

   S Koch and others
   www.researchgate.netpublication/230665879_Critical_advances_in_bridging_
   personal_health_informatics_and_clinical_informatics
3. Informatics in the provider curriculum
   "Integrating informatics into the BSN curriculum: a review of the literature"
   
   Nurse Education Today

   August 2012

   J De Gagne and others
   http://www.sciencedirect.com/science/article/pii/S0260691711002243
4. Healthcare Acquired Infections (HAIs)– new tool
   "New tools aim to improve infection tracking in long-term care"
   
   CIDRAP

   September 19, 2012

   R Roos
   http://www.cidrap.umn.edu/cidrap/content/other/news/sep1912longterm.html

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Quotation of the Day



"It’s like buying a car. You don’t just take the dealer’s word."

- A physician describing his or her use of a “chart biopsy,” whereby the physician looks at the EHR of a patient being admitted from the emergency department to see if he/she agrees with the description of the patient provided by the emergency room staff. See item #4 under Public Health Informatics above.

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About Surveillance and Informatics This Week

Surveillance & Informatics This Week is published every Wednesday except holidays and the final week of the calendar year, plus special issues when warranted. It is distributed only in electronic form and is free of charge. This Week is published by the Public Health Surveillance and Informatics Program Office (proposed), Office of Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention (CDC), Department of Health & Human Services (HHS). The Editor-in-Chief is Richard Jones; Publishers are Oona Powell, MA and Frederic E. Shaw, MD, JD; Contributing Editors are E. Lee Husting, PhD, MPH, Carol Pierannunzi, PhD, Megan Smallwood, and Monica Torres, MBA, with special thanks to Kaneshia S. Poole, MPH. To subscribe, please send an email to RjonesII@cdc.gov. The editor welcomes comments or suggestions from readers.

The content of Surveillance & Informatics This Week is selected solely on the basis of newsworthiness and potential interest to readers. CDC and HHS assume no responsibility for the factual accuracy of items presented from other sources, or the currency of hyperlinks provided. The selection, omission, or content of items does not imply any endorsement or other position taken by CDC or HHS. Opinions expressed by the original authors of items included in This Week, or persons quoted therein, are strictly their own and are in no way meant to represent the opinion or views of CDC or HHS. References to products, trade names, publications, news sources, and non-CDC Web sites are provided solely for informational purposes and do not imply endorsement by CDC or HHS. The findings and conclusions reported in This Week are those of the author(s) and do not necessarily represent the views of CDC or HHS. This Week is in the public domain and may be freely forwarded and reproduced without permission. The original news sources and Surveillance & Informatics This Week should be cited as sources. Readers should contact the cited news sources for the full text of the articles.

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