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Impact of Integrating Public Health Clinical Decision Support Alerts Into Electronic Health Records on Testing for Gastrointestinal Illness

Wu, Winfred Y. MD, MPH; Hripcsak, George MD, MS; Lurio, Joseph MD; Pichardo, Michelle MPH; Berg, Rachel BA; Buck, Michael D. PhD; Morrison, Frances P. MD, MPH, MA; Kitson, Kwame MD; Calman, Neil MD; Mostashari, Farzad MD, ScM

Journal of Public Health Management and Practice: May/June 2012 - Volume 18 - Issue 3 - p 224–227
doi: 10.1097/PHH.0b013e318241555d
Practice Brief Report

Laboratory testing by clinicians is essential to outbreak investigations. Electronic health records may increase testing through clinical decision support that alerts providers about existing outbreaks and facilitates laboratory ordering. The impact on laboratory testing was evaluated for foodborne disease outbreaks between 2006 and 2009. After controlling for standard public health messaging and season, decision support resulted in a significant increase in laboratory testing and may be useful in enhancing public health messaging and provider action.

This study describes that laboratory testing of gastrointestinal illness is essential for public health surveillance of enteric diseases but relies on laboratory test ordering by medical providers.

Primary Care Information Project, New York City Department of Health and Mental Hygiene, Queens, New York (Drs Wu, Buck, and Mostashari); and Department of Biomedical Informatics, Columbia University (Drs Hripcsak, Buck, and Morrison), and Institute for Family Health, (Drs Lurio, Kitson, and Calman, and Mss Pichardo and Berg), New York.

Correspondence: Winfred Y. Wu, MD, MPH, New York City Department of Health and Mental Hygiene, Gotham Center, 42-09 28th St (CN 52), Queens, NY 11101-4132 (

This study was supported by the Centers for Disease Control and Prevention grant P01 HK000029.

The authors thank Amanda Parsons and Marcelle Layton for their careful review of this manuscript.

The authors report no other conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.