TY - JOUR
T1 - Minnesota Electronic Health Record Consortium COVID-19 Project
T2 - Informing Pandemic Response Through Statewide Collaboration Using Observational Data
AU - Winkelman, Tyler N.A.
AU - Margolis, Karen L.
AU - Waring, Stephen
AU - Bodurtha, Peter J.
AU - Khazanchi, Rohan
AU - Gildemeister, Stefan
AU - Mink, Pamela J.
AU - DeSilva, Malini
AU - Murray, Anne M.
AU - Rai, Nayanjot
AU - Sonier, Julie
AU - Neely, Claire
AU - Johnson, Steven G.
AU - Chamberlain, Alanna M.
AU - Yu, Yue
AU - McFarling, Lynn M.
AU - Dudley, R. Adams
AU - Drawz, Paul E.
N1 - Publisher Copyright:
© 2022, Association of Schools and Programs of Public Health.
PY - 2022/3
Y1 - 2022/3
N2 - Objective: Robust disease and syndromic surveillance tools are underdeveloped in the United States, as evidenced by limitations and heterogeneity in sociodemographic data collection throughout the COVID-19 pandemic. To monitor the COVID-19 pandemic in Minnesota, we developed a federated data network in March 2020 using electronic health record (EHR) data from 8 multispecialty health systems. Materials and Methods: In this serial cross-sectional study, we examined patients of all ages who received a COVID-19 polymerase chain reaction test, had symptoms of a viral illness, or received an influenza test from January 3, 2016, through November 7, 2020. We evaluated COVID-19 testing rates among patients with symptoms of viral illness and percentage positivity among all patients tested, in aggregate and by zip code. We stratified results by patient and area-level characteristics. Results: Cumulative COVID-19 positivity rates were similar for people aged 12-64 years (range, 15.1%-17.6%) but lower for adults aged ≥65 years (range, 9.3%-10.7%). We found notable racial and ethnic disparities in positivity rates early in the pandemic, whereas COVID-19 positivity was similarly elevated across most racial and ethnic groups by the end of 2020. Positivity rates remained substantially higher among Hispanic patients compared with other racial and ethnic groups throughout the study period. We found similar trends across area-level income and rurality, with disparities early in the pandemic converging over time. Practice Implications: We rapidly developed a distributed data network across Minnesota to monitor the COVID-19 pandemic. Our findings highlight the utility of using EHR data to monitor the current pandemic as well as future public health priorities. Building partnerships with public health agencies can help ensure data streams are flexible and tailored to meet the changing needs of decision makers.
AB - Objective: Robust disease and syndromic surveillance tools are underdeveloped in the United States, as evidenced by limitations and heterogeneity in sociodemographic data collection throughout the COVID-19 pandemic. To monitor the COVID-19 pandemic in Minnesota, we developed a federated data network in March 2020 using electronic health record (EHR) data from 8 multispecialty health systems. Materials and Methods: In this serial cross-sectional study, we examined patients of all ages who received a COVID-19 polymerase chain reaction test, had symptoms of a viral illness, or received an influenza test from January 3, 2016, through November 7, 2020. We evaluated COVID-19 testing rates among patients with symptoms of viral illness and percentage positivity among all patients tested, in aggregate and by zip code. We stratified results by patient and area-level characteristics. Results: Cumulative COVID-19 positivity rates were similar for people aged 12-64 years (range, 15.1%-17.6%) but lower for adults aged ≥65 years (range, 9.3%-10.7%). We found notable racial and ethnic disparities in positivity rates early in the pandemic, whereas COVID-19 positivity was similarly elevated across most racial and ethnic groups by the end of 2020. Positivity rates remained substantially higher among Hispanic patients compared with other racial and ethnic groups throughout the study period. We found similar trends across area-level income and rurality, with disparities early in the pandemic converging over time. Practice Implications: We rapidly developed a distributed data network across Minnesota to monitor the COVID-19 pandemic. Our findings highlight the utility of using EHR data to monitor the current pandemic as well as future public health priorities. Building partnerships with public health agencies can help ensure data streams are flexible and tailored to meet the changing needs of decision makers.
KW - COVID-19
KW - health disparities
KW - health informatics
KW - infectious diseases
KW - public health surveillance
UR - http://www.scopus.com/inward/record.url?scp=85123741144&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85123741144&partnerID=8YFLogxK
U2 - 10.1177/00333549211061317
DO - 10.1177/00333549211061317
M3 - Article
C2 - 35060411
AN - SCOPUS:85123741144
SN - 0033-3549
VL - 137
SP - 263
EP - 271
JO - Public Health Reports
JF - Public Health Reports
IS - 2
ER -