Public health benefits from EMR network at Rhode Island safety-net clinics

Recent flooding in Rhode Island illustrated why public-health officials are excited about the potential EMRs represent to improve disease surveillance and disaster response.

"The public-health authorities in the state immediately recognized that, after the short-term needs of those affected by the flood were addressed, a potential for exacerbation of such chronic illnesses as asthma and acute illness caused by contaminated water or food might occur," Dr. Jerald Fingerut, medical director of Blackstone Valley Community Health Care, a federally qualified health center in Pawtucket, R.I., writes in the Providence Journal.

"Although databases and health-information exchanges that derive their utility from electronic health records are being developed in the state, these potential tools were not ready to provide the information needed by the Department of Health to monitor the immediate post-flood health effects on Rhode Islanders."

State Health Director David Gifford subsequently issued a request for information about how the department could harness EMR technology in the future. In response, the Rhode Island Health Center Controlled Network, based at the Blackstone Valley clinic, started monitoring its EMR to provide the Department of Health with real-time surveillance of presenting complaints by patients--with all patient-specific identifiers stripped out. It's a function that was built into the network when it launched in 2007.

"Having this infrastructure in place when the recent floods struck Rhode Island provided the added benefit of providing certain surveillance unavailable from any other source in the state. The statewide coverage of network members provided the necessary control on the data, as ZIP codes affected by the disaster could be readily compared with those that were not impacted," Fingerut writes.

"The HCCN was not created to provide a platform for disaster management," he adds. "However, the increasing use of clinical data for routine and emergency care of individuals can now be supplanted with a vehicle allowing for study of the public-health needs of broad segments of the state's population."

To learn more:
- read Fingerut's commentary in the Providence Journal