Recommendation 9

The committee recommends that the Office of the National Coordinator for Health Information Technology expand the minimum data for electronic health records to include behavioral, social, and environmental risk factors for cardiovascular and chronic lung diseases in validated, interoperable ways in order to enhance the quality of surveillance data for these conditions.


Because EHRs are currently in use in only a minority of hospitals and practices, several interim steps are needed before their potential can be realized. Expansion of EHRs to the majority of clinical care settings will require significant investment in purchasing necessary equipment and software as well as staff training. Additional resources will need to be devoted to major issues such as interoperability of EHR systems and harmonization of data standards.

Many existing sources of surveillance information provide high-quality data that are critical to understanding the trajectory of cardiovascular and chronic lung diseases. However, those data lack standardization and cannot be linked across sources, and many of them are not readily accessible. Furthermore, there is a need for collection of data that can be analyzed by demographic variables such as race/ethnicity, socioeconomic status, and geography. The committee believes the recommendations provided in this report lay the foundation or framework and the basics of the infrastructure needed for integrating and enhancing current CVD and COPD surveillance activities so that they can evolve into the complex, interdependent system needed.


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