Linking Data From Health Surveys and Electronic Health Records: A Demonstration Project in Two Chicago Health Center Clinics.

Fikirte Wagaw,Fred Rachman,Catherine A Okoro,Sunkyung Kim,Jessica Park

doi:10.5888/pcd15.170085

Abstract

IntroductionMonitoring and understanding population health requires conducting health-related surveys and surveillance. The objective of our study was to assess whether data from self-administered surveys could be collected electronically from patients in urban, primary-care, safety-net clinics and subsequently linked and compared with the same patients’ electronic health records (EHRs).MethodsData from self-administered surveys were collected electronically from a convenience sample of 527 patients at 2 Chicago health centers from September through November, 2014. Survey data were linked to EHRs.ResultsA total of 251 (47.6%) patients who completed the survey consented to having their responses linked to their EHRs. Consenting participants were older, more likely to report fair or poor health, and took longer to complete the survey than those who did not consent. For 8 of 18 categorical variables, overall percentage of agreement between survey data and EHR data exceeded 80% (sex, race/ethnicity, pneumococcal vaccination, self-reported body mass index [BMI], diabetes, high blood pressure, medication for high blood pressure, and hyperlipidemia), and of these, the level of agreement was good or excellent (κ ≥0.64) except for pneumococcal vaccination (κ = 0.40) and hyperlipidemia (κ = 0.47). Of 7 continuous variables, agreement was substantial for age and weight (concordance coefficients ≥0.95); however, with the exception of calculated survey BMI and EHR–BMI (concordance coefficient = 0.88), all other continuous variables had poor agreement.ConclusionsSelf-administered and web-based surveys can be completed in urban, primary-care, safety-net clinics and linked to EHRs. Linking survey and EHR data can enhance public health surveillance by validating self-reported data, completing gaps in patient data, and extending sample sizes obtained through current methods. This approach will require promoting and sustaining patient involvement.

Highlights

Monitoring and understanding population health requires conducting health-related surveys and surveillance
Of 7 continuous variables, agreement was substantial for age and weight; with the exception of calculated survey body mass index (BMI) and electronic health record (EHR)–BMI, all other continuous variables had poor agreement
Self-administered and web-based surveys can be completed in urban, primary-care, safety-net clinics and linked to EHRs

Summary

Introduction

Monitoring and understanding population health requires conducting health-related surveys and surveillance. The objective of our study was to assess whether data from self-administered surveys could be collected electronically from patients in urban, primarycare, safety-net clinics and subsequently linked and compared with the same patients’ electronic health records (EHRs). The Behavioral Risk Factor Surveillance System (BRFSS), for example, is a state-based system of telephone surveys that collect data on health-risk behaviors, chronic conditions, use of preventive services, and healthrelated quality of life (HRQoL) of adults [1]. EHRs can help identify patients needing medical care, disease management, preventive health services, and behavioral counseling [2,3,14,15,16,17]. EHRs can help control rising health care costs by eliminating unnecessary tests, procedures, and prescriptions [17]

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