New York City is developing the NYC Macroscope, a population health surveillance system that uses electronic health records (EHRs) to track conditions managed by primary care practices that are important to public health.
Using the NYC Macroscope, we'll be able to monitor in real-time the prevalence of chronic conditions, such as obesity, diabetes and hypertension, as well as smoking rates and flu vaccine uptake.
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How will it work?
The NYC Macroscope will rely on data from the Primary Care Information Project which helps ambulatory providers in underserved areas adopt EHRs with population management tools to improve the quality of healthcare for the most vulnerable New Yorkers.
The NYC Macroscope will be validated by comparing ambulatory EHR data with data from the 2013 NYC Health and Nutrition Examination Survey (NYC HANES 2013), a gold-standard, population-based health survey. The lessons learned in developing the NYC Macroscope will be useful to other agencies and researchers interested in using EHRs to monitor population health.
Why use electronic health records?
Electronic health records (EHRs) are rapidly becoming the standard of care for office-based medical practices, as a result of federal incentive programs encouraging their uptake by healtlh care professionals and institutions. As of 2012, 72% of office-based medical practices nationwide were using some kind of EHR system.
EHRs that have been constructed with population health management goals in mind can complement and expand the capacity of existing surveillance systems by capturing care events economically and with relative completeness.
About the project
The NYC Macroscope is part of a larger project, Innovations in Monitoring Population Health, conducted by the Health Department and the CUNY School of Public Health in partnership with the Fund for Public Health in New York and the Research Foundation of the City University of New York. Support for the larger project is primarily provided by the de Beaumont Foundation, with additional support from the Robert Wood Johnson Foundation, Robin Hood, the New York State Health Foundation, and the Doris Duke Charitable Foundation.
Phase I (completed June 2013):
Publish Developing an Electronic Health Record-Based Population Health Surveillance System, a planning document to operationalize the NYC Macroscope and describe the methods to assess the validity of NYC Macroscope estimates.
Phase II (June 2013 - June 2014):
Collect EHR data on priority health indicators:
- Chronic disease risk factors (blood pressure, body mass index, blood sugar, cholesterol)
- Chronic disease prevalence, treatment and control (hypertension, diabetes, high cholesterol)
- Behavioral health (tobacco use, depression)
- Receipt of clinical preventive services (influenza immunization)
Phase III (June 2014 - December 2015):
Issue a report with year-one data from the NYC EHR surveillance system, validation study results and lessons learned.
Scientific Advisory Group
The NYC Macroscope was developed with input from the project's Scientific Advisory Group including public health professionals, clinicians and academics working in public health surveillance and informatics.
Health Information Technology Transformation
New York State Department of Health
Neil Calman, MD, ABFP, FAAFP
Institute for Family Health
Ralph J. Coates, PhD
Office of Surveillance, Epidemiology, and Laboratory Services
Centers for Disease Control and Prevention
Marc Gourevitch, MD, MPH
Department of Population Health
New York University
Cristal Simmons, MPH
Chicago Department of Public Health
Patrick Remington, MD, MPH
University of Wisconsin School of Medicine and Public Health
David Ross, ScD
Public Health Informatics Institute
New York eHealth Collaborative
Tyler Williamson, PhD
Canadian Primary Care Sentinel Surveillance Network (CPCSSN)