MDPHnet: secure, distributed sharing of electronic health record data for public health surveillance, evaluation, and planning

Abstract

Electronic health record systems contain clinically detailed data from large populations of patients that could significantly enrich public health surveillance. Clinical practices' security, privacy, and proprietary concerns, however, have limited their willingness to share these data with public health agencies. We describe a novel distributed network for public health surveillance called MDPHnet. The system allows the Massachusetts Department of Public Health (MDPH) to initiate custom queries against participating practices' electronic health records while the data remain behind each practice's firewall. Practices can review proposed queries before execution and approve query results before releasing them to the health department. MDPH is using the system for routine surveillance for priority conditions and to evaluate the impact of public health interventions.

FIGURE 1—

Influenza vaccine and influenza-like-illness visit counts: Massachusetts, September 2009–March 2012. Note. Data were gathered and aggregated from the electronic health records of Atrius Health and the Massachusetts League of Community Health Centers using MDPHnet.

FIGURE 2—

Hemoglobin A1C test counts among Hispanic women aged 18–45 years prior to and following the airing of a public service announcement encouraging diabetes testing: Massachusetts, September 2009–March 2012.