Presenting Author: Mary Figgatt, MPH, Philadelphia Department of Public Health

ABSTRACT

Background: Public health entities use a variety of sources to monitor prevalence of chronic conditions and health behaviors, including heavy reliance on local and national surveys. These surveys are limited by rapidly declining response rates and ongoing modifications to survey cycles, requiring the use of new data sources for ongoing surveillance.

Objectives: To demonstrate feasibility of using CHC EHRs to describe prevalence of select chronic conditions and smoking among low-income populations in Philadelphia.

Methods: In partnership with Health Federation of Philadelphia, data for calendar year 2015 were obtained from a large, geographically dispersed network of CHC EHRs that interface with a data warehouse. Chronic disease status was defined using ICD-9/10 diagnosis codes and smoking status was self-reported during clinical assessment for patients with at least one medical visit during the study period. Prevalence estimates were compared to estimates from the Public Health Management Corporation (PHMC) 2014/2015 Household Health Survey (HHS), for the entire and low income populations separately.

Results: There were 78,205 adults and 35,363 children included in this analysis. Among adults, 41% were obese, 33% reported being current smokers, 34% had hypertension, and 15% had diabetes. Among children less than age 18, 18% were obese, 0.5% reported being current smokers, 20% had asthma, and 0.3% had diabetes. Most EHR-based estimates were not significantly different than PHMC HHS estimates for low-income populations and tended to be higher than estimates for the entire population.

Implications: EHR surveillance represents a novel way to characterize chronic disease trends while leveraging a rich data source. While representative city-wide, these data provide valuable estimates of disease prevalence among low income populations, variations among subgroups, and offer the potential for assessing impact of programs or policies.

Authors: Mary Figgatt, MPH; Jessica Chen, MPH; and Raynard Washington, PhD, MPH.