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Electronic Health Records as a Resource for Public Health Surveillance

2016 | Download the paper.

Case Study of Glycohemoglobin Testing & Diabetes Surveillance

Electronic health records (EHR) are the digital version of a patient's paper chart and may include medical history, diagnoses, prescriptions, lab results, and other critical health information. EHR may provide data that—in comparison to more traditional health data sources, such as hospital discharge records and community health surveys—are more timely, more accurate, and better able to describe health disparities in local communities. However, there have been few efforts to date to understand EHR's utility for chronic disease surveillance.

As part of a National Environmental Health Tracking Program initiative to explore the utility of EHR for chronic disease surveillance and in partnership with Kaiser Permanente Northern California, the California Environmental Health Tracking Program (CEHTP) conducted a pilot study to assess the feasibility, validity, and utility of EHR. The assessment focused on diabetesa disease with environmental links and of high concern to local health departmentsin two California counties. Using records for blood levels of glycohemoglobin, which indicates how well blood sugar is being controlled, CEHTP found that EHR were useful for documenting diabetes disparities by geography, race, and income.

Download the full paper, which: 

  • Describes the state of EHR use in California Identify challenges in EHR adoption and data reporting
  • Analyzes the practicality, validity, and surveillance utility of glycohemoglobin as a marker for diabetes prevalence or control
  • Describes the potential utility and barriers for use of EHR in public health surveillance
  • Provides an analysis of diabetes control for Contra Costa and Solano Counties

The California Environmental Health Tracking Program (CEHTP) is a collaboration of the Public Health Institute and the California Department of Public Health. CEHTP is part of a national initiative coordinated by the National Environmental Public Health Tracking Program.


Max Richardson, MPH, MCP; Susan Paulukonis, MPH; , Eric Roberts, Paul English

Produced through PHI's:

Tracking California