Post-Ebola ‘soul searching’ prompts the CDC to rethink data collection and clinical decision support

The CDC is looking for ways to pull data from EHRs to reduce the burden on physicians and keep pace with diseases outbreaks.

Between infectious outbreaks like Ebola and Zika, not to mention an ongoing battle against the opioid epidemic, it’s been a busy three years for the Centers for Disease Control and Prevention.

Chesley Richards, M.D., the deputy director for public health scientific services and the director of the Office of Public Health Scientific Service, is the first to admit it’s been a bumpy ride for the agency, particularly when it comes to collecting and analyzing public health data to better manage those threats.

During the Ebola outbreak, the agency “stumbled along the way,” Richards said during a panel at the Office of the National Coordinator for Health IT’s annual meeting on Thursday, offering a frank assessment of the CDC's growing pains as it navigates new data-sharing paradigms. 

"We learned as we went because it was a new situation," he said. "Clinical decision support became a real issue for us."

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The CDC has made some notable investments in data collection, and agency officials have said it is moving toward cloud-based databases and advancing data-sharing capabilities to integrate data from EHRs. Richards’ comments underscored the notion that interoperability goes well beyond provider-to-provider interactions.

Richards, who oversees the National Center for Health Statistics (NCHS) and the Center for Surveillance, Epidemiology and Laboratory Services (CSELS), said the experience with Ebola led to “some soul searching” about the CDC’s role in the clinical decision support continuum—namely, should the public health agency develop apps to support clinicians during an outbreak, or quickly release guidelines in a format that developers can easily spin off into tools.

That discussion has bled over into the opioid epidemic where the agency is looking for ways to write guidelines that developers can use instantaneously. 

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The CDC’s other challenge revolves around quickly collecting and analyzing data as outbreaks occur, which comes with some growing pains for an agency that historically relied on primary data collection. Thanks to an unprecedented level of international travel, that approach no longer keeps pace with the speed of an outbreak.

Perhaps more importantly, Richards said the CDC is looking for ways to streamline reporting to limit the burden on clinicians. For that reason, the agency is focused on extracting data from EHRs in a way that doesn't interfere with clinical processes. Researchers have noted that medical records remain an untapped public health resource that can help identify community-specific illnesses.

“We're finding that we need EHR data that can move quickly, give us the basic information we need, and then target our primary data collection for those things that can't be collected in that modality,” he said.