Innovations in Monitoring Public Health: The New York City Macroscope

Recipient: CUNY School of Public Health

Electronic Health Records (EHRs) are increasingly being adopted to improve clinical care, but they also have great potential to monitor health at the population level.

To date, there has been relatively little focus on using EHRs for population health surveillance. Improved surveillance allows health officials to strategically target resources, and provides data to guide and evaluate public health initiatives and policies.

With their increasing reach, EHRs can provide rapid access to large volumes of real-time standardized health data, such as body mass index and blood pressure, as well as information on delivery of clinical preventive services and chronic disease management. Local, regional, and national governments, large health care organizations, insurance companies, and academic research centers are in the early stages of learning how to use aggregated data from EHRs to monitor health, and inform health care policies and programs.

With funding from the de Beaumont Foundation, the Robert Wood Johnson Foundation, Robin Hood, and the New York State Health Foundation, New York City is developing the NYC Macroscope, a system that uses primary care practice EHRs to track conditions that are important to public health, with a focus on chronic conditions. The NYC Macroscope will be validated by comparing outpatient EHR data with data obtained from the 2013 New York City Health and Nutrition Examination Survey (NYC HANES 2013), a gold standard, population-based examination survey lead by the CUNY School of Public Health in partnership with the NYC Health Department.

The lessons learned in developing the NYC Macroscope will be useful to other agencies and researchers interested in using electronic health records to monitor population health. These lessons can also inform national efforts to interpret and use EHR data, to apply standards to EHR data, and to capitalize on the exchange of public health-oriented data incentivized by meaningful use.