TY - JOUR AU - Hota, Bala AU - Casey, Paul AU - McIntyre, Anne F AU - Khan, Jawad AU - Rab, Shafiq AU - Chopra, Aneesh AU - Lateef, Omar AU - Layden, Jennifer E PY - 2022 DA - 2022/9/27 TI -基于标准的全市公共卫生信息交流以应对COVID-19:开发研究JO - JMIR公共卫生监测SP - e35973 VL - 8 IS - 9kw -公共卫生KW -信息学KW -监测KW -疾病监测KW -流行病学KW -健康数据KW -电子健康记录KW -数据枢纽KW -急性护理医院KW - COVID-19 KW -大流行KW -数据治理AB -背景:疾病监测是公共卫生的一项重要职能，提供有关疾病负担以及疾病的临床和流行病学参数的基本信息，是有效和及时追踪病例和接触者的重要组成部分。COVID-19大流行证明了疾病监测在维护公共卫生方面的重要作用。理论上，电子健康记录(EHR)的有意义使用所提供的标准数据格式和交换方法应该能够在破坏性卫生保健事件(如大流行)的背景下实现快速的卫生保健数据交换。在现实中，获取数据仍然具有挑战性，即使可以获得数据，也往往不符合受监管的标准。目的:我们寻求使用已投入使用的规范互操作性标准，以提高对区域床位容量的认识，并加强对接受SARS-CoV-2检测的患者的流行病学风险因素和临床变量的捕捉。我们描述了执行公共卫生命令所需的技术和操作组件、治理模型和时间表，该命令要求芝加哥辖区内的医院通过电子病历进行数据的电子报告。我们还评估了数据源、基础设施需求、提供给平台的数据的完整性以及连接这些数据源的能力。方法:根据公共卫生命令，要求芝加哥所有急症护理医院提交数据，我们开发了技术基础设施，以结合来自这些EHR系统的多个数据馈送-一个区域数据中心，以加强公共卫生监测。 A cloud-based environment was created that received ELR, consolidated clinical data architecture, and bed capacity data feeds from sites. Data governance was planned from the project initiation to aid in consensus and principles for data use. We measured the completeness of each feed and the match rate between feeds. Results: Data from 88,906 persons from CCDA records among 14 facilities and 408,741 persons from ELR records among 88 facilities were submitted. Most (n=448,380, 90.1%) records could be matched between CCDA and ELR feeds. Data fields absent from ELR feeds included travel histories, clinical symptoms, and comorbidities. Less than 5% of CCDA data fields were empty. Merging CCDA with ELR data improved race, ethnicity, comorbidity, and hospitalization information data availability. Conclusions: We described the development of a citywide public health data hub for the surveillance of SARS-CoV-2 infection. We were able to assess the completeness of existing ELR feeds, augment those feeds with CCDA documents, establish secure transfer methods for data exchange, develop a cloud-based architecture to enable secure data storage and analytics, and produce dashboards for monitoring of capacity and the disease burden. We consider this public health and clinical data registry as an informative example of the power of common standards across EHRs and a potential template for future use of standards to improve public health surveillance. SN - 2369-2960 UR - https://publichealth.www.mybigtv.com/2022/9/e35973 UR - https://doi.org/10.2196/35973 UR - http://www.ncbi.nlm.nih.gov/pubmed/35544440 DO - 10.2196/35973 ID - info:doi/10.2196/35973 ER -