Structuring text and standardizing data for clinical and population health applications

Extract

The increasing adoption of Electronic Health Records (EHR) systems in the USA has resulted in many new studies. In this issue of JAMIA, Krist (See page 764) reports on needed functionality to better support primary care, while Feeley (See page 772) describes how cancer care can benefit from information technology. However, it is well known that the quality of EHR notes is highly variable. Burke (See page 910) proposes an instrument to assess the quality of EHR clinical notes that will help make comparisons across providers and inform the development of systems. We are just starting to quantify and fully understand the limitations of current EHR systems. Hanauer (See page 925) compares associations found in structured diagnoses in clinical datasets and associations found in Medline. The study reveals that there is not much concordance among these sources, which calls for further investigation in this area, especially since electronic surveillance for public health or quality improvement often relies on EHR data. Examples are found in articles by Wang (See page 938) and de Bruin (See page 942), which report on the use of electronic sources for tuberculosis and nosocomial infection surveillance, respectively.