ESP (Electronic medical record Support for Public health) is an open source software application that can extract data from electronic health records (EHRs), organize it into a standard format, and apply sophisticated algorithms to find conditions of public health interest. ESP is installed locally and operates behind the host practice’s firewall. In conjunction with PopMedNet, an open source software application that facilitates the creation and operation of distributed health data querying networks, providers can query their data and allow/deny health-department-initiated queries on their EHRs without the need for any data to leave the provider’s system.
In Massachusetts, we used ESP combined with PopMedNet to create MDPHnet. MDPHnet enables participating medical practices (currently Atrius Health, Cambridge Health Alliance, and the Massachusetts League of Community Health Centers) to provide automated, near-real-time information to the Massachusetts Department of Public Health (MDPH) about notifiable conditions and chronic diseases. About 1.5 million patients are represented total; 22% of the total population of Massachusetts. These data can help MDPH and providers identify disparities in health status, care patterns, and outcomes, and inform targeted inventions for the most vulnerable members of the population.
The data visualization tool RiskScape was developed by DPM for MDPH to provide up-to-date, high-level, and customizable summaries of specific health measures using the data from MDPHnet. Estimates are limited to locales in which MDPHnet covers at least 100 patients in the census population. RiskScape currently provides near-real time rates of conditions such as diabetes, smoking status, depression, obesity, and more, throughout the state. Users can drill down and get more information on these conditions by zip code, age, race/ethnicity and presence of other comorbidities as well as view changes over time.
Current projects conducted using ESP/MDPHnet include: 1) an evaluation of the Prevention Wellness Trust Fund Initiative which uses MDPHnet to detect changes in health disparities in nine Massachusetts communities, and 2) creation of an algorithm to flag eligible candidates for Pre-Exposure Prophylaxis (PrEP), a daily medication that can drastically reduce chances of contracting HIV.
Future plans for ESP/MDPHnet include involving additional partners and developing detection algorithms for additional conditions of interest.
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, 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, MD, MPH
Funder: Massachusetts Department of Public Health