CDC, ONC Target EHR-Based Ebola Screening

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An initiative launched last year by the Centers for Disease Control and Prevention and the Office of the National Coordinator for Health IT to help providers meet Stage 1 and 2 meaningful use public health objectives is now focusing its efforts on Ebola electronic screening tools.

In August 2013, CDC and ONC established the Public Health Electronic Health Records Vendors Collaboration Initiative. However, with recently confirmed cases of Ebola in the United States, the initiative—which includes public health practitioners and EHR vendors—is currently aimed at trying to get vendors to configure EHR systems to support screening protocols for the deadly disease.

“The overall goal here is for us to explore ways in which the electronic medical record can serve as a prompt to help our healthcare professionals around the country identify individuals that may be at risk for Ebola,” said Dana Meaney Delman, M.D., deputy lead of CDC’s Medical Care Task Force (Ebola Response), during an Oct. 16 CDC/ONC webinar soliciting industry feedback.

“This is a special edition of our normal community of practice calls that we hold with public health and the EHR vendor community,” added Jim Daniel, public health coordinator at ONC. “We do meet on a monthly basis. Please send an email to so you can join this group. We talk about other public health and meaningful use measures normally, and we’ll be focusing on Ebola as long as we need to.”

According to a statement from the group, “the EHR vendor community has responded with components within their respective tools to address Ebola and assist within a healthcare environment.” Jon White, M.D., ONC’s acting chief medical officer, told the webinar audience on Thursday that CDC and ONC will be having a separate follow-on call with members of the HIMSS Electronic Health Record Association to gain input.

The CDC has developed a clinical algorithm for “evaluation of the returned traveler” and a checklist for patients being evaluated in the U.S. for Ebola. The objective of the Public Health EHR Vendors Collaboration Initiative is to include a travel history and assessment of pertinent clinical signs and symptoms in an electronic format that can help clinicians diagnose patients infected with Ebola and to isolate them. According to Delman, CDC wants to “ensure that there are mechanisms for healthcare providers to rapidly identify individuals that may have suspected Ebola” and “how we can translate this algorithm into an electronic medical record prompt and perhaps even a decisional tool.”

A patient's travel history, in particular, is seen as a critical component in properly identifying and confirming a case of Ebola based on symptoms consistent with the virus. CDC has called for increased vigilance by healthcare providers in inquiring specifically about a patient’s history of travel to West Africa—ground zero for the Ebola outbreak.

In related news, mapping and modeling software is helping to track confirmed cases of Ebola infections and to predict where the outbreak might spread geographically over time, according to Chris Woods, M.D., with the Duke Global Health Institute. Citing modeling data from the CDC, Woods revealed that there are basically two scenarios for the Ebola epidemic over the next six months.

The best case scenario, he said, is one in which “70 percent of those affected are put into healthcare systems and into isolation, removed from the general population—where it’s about 18 percent right now.” However, Woods warned that “if things, conversely, continue as they have been—doubling rates every couple of weeks—we’re looking at 1 to 1.5 million cases over the next six months.” And, he added, “it increases the likelihood we’re going to have more and more exposures of the type we’ve had in Dallas.” 

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