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Looking For TroubleMichael Morgenstern

Looking for Trouble (continued)

Mapping Community Health

If you’ve ever sat watching your doctor tap away on a laptop, you’ve witnessed the rise of EMRs firsthand. According to the CDC, the percentage of office-based physicians using some form of electronic record–keeping system has rocketed from roughly 17 to 70 percent over the past decade.

Joshua Sharfstein, Maryland’s Secretary of Health and Mental Hygiene, is one of many public health leaders hoping to use this wealth of data to look across populations. His ideas offer a glimpse of the ways EMRs might be used to reach beyond the doctor’s office.

“One of the things that we’re really interested in is mapping community health,” says Sharfstein, MD. “If you have a map, you might say, ‘All these different doctors are seeing what looks to them like a one-on-one phenomenon.’ But you can see actually it’s a certain community where there are very high rates of asthma. And maybe there’s something going on here.”

Sharfstein’s ultimate goal is to put granular health data in the hands of local organizations. “If there’s an anti-smoking effort,” says Sharfstein, “maybe the goal today is to hit the whole county. But if you knew that there was a very high concentration of smokers in a particular area and they were having very poor health outcomes, you might target particular buildings.”

In 2009, Maryland took an important, and increasingly common, step toward making such scenarios feasible. It created a health information exchange to expedite the sharing of records from doctors and hospitals across the state—ensuring those records are available anytime and anywhere. That’s useful for individual patients, and it also can be useful for broader trendspotting efforts with obvious public health benefit.

Still, data can’t speak for itself. In essence, Sharfstein faces the same basic challenge as JHHC—figuring out how to extract data efficiently and, ideally, learning what it can tell you about the future.

That’s where Weiner and CPHIT can help.

"One of the things that we’re really interested in is mapping community health."—Joshua Sharfstein


  • Ed Childs

    Nashville T n 06/12/2013 01:09:57 PM

    I have worked for 8 years trying to address the needs of patients with multiple chronic conditions. Using ICD and CPT diagnostic codes matched with prescriptions and then scanned with episode-based predictive software works best. Long-term solutions require individual medical records monitored by nurse navigators.

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