Automated detection and reporting of notifiable diseases using electronic medical records versus passive surveillance--massachusetts, June 2006-July 2007

Electronic medical record (EMR) systems have the potential to improve reporting of notifiable diseases beyond either traditional clinician-initiated or automated laboratory-based reporting systems, including disease surveillance that is timelier, complete, and clinically detailed. This report summarizes findings from a pilot EMR-based electronic surveillance system in Massachusetts called the Electronic Support for Public Health (ESP), which documented increases of 39% in reported chlamydia and 53% in reported gonorrhea for the period June 2006–July 2007, compared with the existing passive surveillance system.  All ESP case reports included patient treatment information and pregnancy status. In contrast, passive surveillance reports included pregnancy status for 5% of cases and treatment information for 88% of cases. ESP reported 81 cases of pregnancy in females with chlamydia or gonorrhea that were not noted on passive surveillance reports. Passive surveillance reports had a 5% rate of transcription errors, compared with no errors in ESP reports.