In 2006, Massachusetts Department of Public Health, the Harvard Medical School/Harvard Pilgrim Health Care Institute Department of Population Medicine (DPM/HPHCI), and the Boston Children's Hospital Informatics Program established a Center of Excellence in Public Health Informatics funded by the U.S. Centers for Disease Control and Prevention (CDC).

This collaboration developed Electronic medical record Support for Public Health (ESP), an open source software application that uses EHR data to identify notifiable disease cases and automatically submit identifiable case reports using secure protocols to state health departments. ESP is compatible with any EHR system and with health information exchanges.

ESP uses purpose-built algorithms to integrate patients’ laboratory tests, medication prescriptions, diagnoses, prior results, and vital signs to distinguish acute from chronic disease, active versus latent infection, and current versus resolved infection. This strategy also allows ESP to detect and report diseases that may not have positive laboratory tests. ESP’s case reports are enriched by the availability of EHR data.  ESP reports include detailed patient and clinician contact information to facilitate public health follow-up.

The timeliness, granularity, completeness, and accuracy of ESP reports are a tremendous benefit to health departments and will be useful to local boards of health in case investigation and response. They enable resource-strapped departments to rapidly identify the handful of highly actionable, high yield cases from amongst the thousands of undifferentiated cases routinely reported by ELR systems and clinicians.

Related Publications

Birkhead GS, Klompas M, Shah NR. Uses of electronic health records for public health surveillance to advance public health. Annu Rev Public Health. 2015 Mar 18;36345-59. Epub 2015 Jan 2.

Vogel J, Brown JS, Land T, Platt R, Klompas M. MDPHnet: secure, distributed sharing of electronic health record data for public health surveillance, evaluation, and planning. Am J Public Health. 2014 Dec;104(12):2265-70. Epub 2014 Oct 16.

Eggleston EM, Klompas M. Rational use of electronic health records for diabetes population management. Curr Diab Rep. 2014 Apr;14(4):479.

Yih WK, Cocoros NM, Crockett M, Klompas M, Kruskal BA, Kulldorff M, Lazarus R, Madoff LC, Morrison MJ, Smole S, Platt R. Automated influenza-like illness reporting--an efficient adjunct to traditional sentinel surveillance. Public Health Rep. 2014 Jan-Feb;129(1):55-63.

Klompas M, Eggleston E, McVetta J, Lazarus R, Li L, Platt R. Automated detection and classification of type 1 versus type 2 diabetes using electronic health record data. Diabetes Care. 2013 Apr;36(4):914-21. Epub 2012 Nov 27.

Klompas M, McVetta J, Lazarus R, Eggleston E, Haney G, Kruskal BA, Yih WK, Daly P, Oppedisano P, Beagan B, Lee M, Kirby C, Heisey-Grove D, DeMaria A, Platt R. Integrating clinical practice and public health surveillance using electronic medical record systems. Am J Public Health. 2012 Jun;102 Suppl 3S325-32.

Allen-Dicker J, Klompas M. Comparison of electronic laboratory reports, administrative claims, and electronic health record data for acute viral hepatitis surveillance. J Public Health Manag Pract. 2012 May-Jun;18(3):209-14.

Klompas M, Kleinman K, Khan Y, Evans RS, Lloyd JF, Stevenson K, Samore M, Platt R. Rapid and reproducible surveillance for ventilator-associated pneumonia. Clin Infect Dis. 2012 1;54(3):370-7.

Klompas M, Murphy M, Lankiewicz J, McVetta J, Lazarus R, Eggleston E, Daly P, Oppedisano P, Beagan B, Kirby C, Platt R. Harnessing electronic health records for public health surveillance. Online J Public Health Inform. 2011 Dec 22. [Epub ahead of print].

Klompas M, Kulldorff M, Vilk Y, Bialek SR, Harpaz R. Herpes zoster and postherpetic neuralgia surveillance using structured electronic data. Mayo Clin Proc. 2011 Dec;86(12):1146-53. Epub 2011 Oct 13.

Klompas M, Khan Y, Kleinman K, Evans RS, Lloyd JF, Stevenson K, Samore M, Platt R. Multicenter evaluation of a novel surveillance paradigm for complications of mechanical ventilation. PLoS ONE. 2011 22. [Epub ahead of print].

Calderwood MS, Platt R, Hou X, Malenfant J, Haney G, Kruskal B, Lazarus R, Klompas M. Real-time surveillance for tuberculosis using electronic health record data from an ambulatory practice in eastern Massachusetts. Public Health Rep. 2010 Nov-Dec;125(6):843-50.

Lazarus R, Klompas M, Campion FX, McNabb SJ, Hou X, Daniel J, Haney G, DeMaria A, Lenert L, Platt R. Electronic Support for Public Health: validated case finding and reporting for notifiable diseases using electronic medical data. J Am Med Inform Assoc. 2009 Jan-Feb;16(1):18-24. Epub 2008 Oct 24.

Klompas M, Lazarus R, Platt R, Hou X, Campion FX, Kruskal B, Haney G, Dumas W, Daniel J, DeMaria A, McNabb SJN. Automated Detection and Reporting of Notifiable Diseases Using Electronic Medical Records Versus Passive Surveillance — Massachusetts, June 2006—July 2007. MMWR Morbidity and Mortality Weekly Report 2008;57:373-6.

Klompas M, Haney G, Church D, Lazarus R, Hou X, Platt R. Automated identification of acute hepatitis B using electronic medical record data to facilitate public health surveillance. PLoS ONE. 2008 Jul 9. [Epub ahead of print].

Principal Investigator: Michael Klompas

Funder: Massachusetts Department of Public Health