Illinois Morbidity and Mortality Bulletin September 2015 Vol. 1, Issue 2 Page 1 Meaningful Use of Clinical Data for Public Health in Illinois: A Review of Experience and Challenges Meaningful Use is a term well known in the clinical health data and exchange world, but how does it affect public health practice? For years, public health agencies have been the recipients of data from the medical community for purposes of identifying outbreaks, conducting disease surveillance, and analyzing trends. Often, that data flow was delayed, incomplete, and only available after much effort by local health departments. Advances in the adoption of electronic medical records (EMRs) and laboratory systems provide public health agencies with new opportunities to receive those data directly from automated, electronic submissions in near real-time. Contrast this with legacy systems…read more Childhood Lead Exposure, Testing Rate, and Blood Lead Poisoning Prevalence in Illinois and Chicago, 1996-2012 Lead is neurotoxic and particularly harmful to the developing nervous system of young children. Lead exposure can affect a child's ability to think, learn, or behave. Illinois ranks second nationally in number and percentage of lead poisoned children. Childhood blood lead data reported to the Illinois Department of Public Health (IDPH) were analyzed….read more Message from Director Shah Welcome to the second issue of the Illinois Morbidity and Mortality Bulletin (IMMB), a Department-wide publication that we created last year to present topics of interest to public health communities in Illinois through scientific analysis and interpretation of data. In this issue, Judy Kauerauf and Stacey Hoferka review the IDPH's experience with and challenges surrounding meaningful use of clinical data for public health in Illinois. In the second article, Dr. Frida Fokum of the Division of Environmental Health and Dr. Mohammed Shahidullah of the Illinois Center for Health Statistics collaborated with Emile Jorgensen of the Chicago Department of Public Health and Dr. Helen Binns of the Ann & Robert H. Lurie Children's Memorial Hospital of Chicago to analyze childhood blood lead data as reported to the Department over the period of 1996 to 2012. We hope you find these articles interesting and we look forward to continued dissemination of health data and information from IDPH. We would also encourage contributions from public health professionals at the state and local levels. Please send your manuscripts to the bulletin's editor, Dr. Tiefu Shen at [email protected](217.785.1873) Nirav D. Shah, M.D., J.D. Director Illinois Department of Public Health In this issue Meaningful Use of Clinical Data for Public Health in Illinois: A Review of Experience and Challenges Page 2 Childhood Lead Exposure, Testing Rate, and Blood Lead Poisoning Prevalence in Illinois and Chicago, 1996-2012. Page 13
33
Embed
Illinois Morbidity and Mortality Bulletindph.illinois.gov/sites/default/files/publications/immb... · 2016-04-08 · Illinois Morbidity and Mortality Bulletin September 2015 Vol.
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Illinois Morbidity and Mortality Bulletin
September 2015 Vol. 1, Issue 2 Page 1
Meaningful Use of Clinical Data for Public Health in
Illinois: A Review of Experience and Challenges Meaningful Use is a term well known in the clinical health data and exchange
world, but how does it affect public health practice? For years, public health
agencies have been the recipients of data from the medical community for
purposes of identifying outbreaks, conducting disease surveillance, and
analyzing trends. Often, that data flow was delayed, incomplete, and only
available after much effort by local health departments. Advances in the
adoption of electronic medical records (EMRs) and laboratory systems provide
public health agencies with new opportunities to receive those data directly
from automated, electronic submissions in near real-time. Contrast this with
legacy systems…read more
Childhood Lead Exposure, Testing Rate, and Blood
Lead Poisoning Prevalence in Illinois and Chicago,
1996-2012 Lead is neurotoxic and particularly harmful to the developing nervous system
of young children. Lead exposure can affect a child's ability to think, learn, or
behave. Illinois ranks second nationally in number and percentage of lead
poisoned children. Childhood blood lead data reported to the Illinois
Department of Public Health (IDPH) were analyzed….read more
14. Illinois Department of Healthcare and Family Services. Illinois Health Connect Bonus Payment for High Performance. http://www.illinoishealthconnect.com/provider/qualitytools/bonuspayment.aspx
(downloaded April, 08, 2015)
Illinois Morbidity and Mortality Bulletin
September 2015 Vol. 1, Issue 2 Page 22
15. Chicago Tribune. Worrisome lead levels in Illinois children (data). Chicago Tribune Graphics. May 1,
Figure 1. High Risk ZIP Codes for Childhood Lead Poisoning in Illinois and the City of Chicago
Source: Illinois Department of Public Health, Lead Program Surveillance Database and U.S. CENSUS
Note: All of the city of Chicago is designated by the Department as a high risk area for childhood lead poisoning.
Illinois Morbidity and Mortality Bulletin
September 2015 Vol. 1, Issue 2 Page 25
Figure 2. Percent of Pre-1980 Housing Units by Illinois County and High-Risk ZIP Codes for Childhood
Lead Poisoning.
Note: All ZIP codes of the city of Chicago are designated by the Department as high risk areas for
childhood blood lead poisoning. Out of 1.2 million housing units in Chicago, a total of 82.3 percent
were pre-1980.
Illinois Morbidity and Mortality Bulletin
September 2015
Figure 3. Testing Rates for Childhood Blood Lead Prevalence in Illinois and Chicago, 1996
Source: Illinois Department of Public Health, Lead Program
Department of Public Health, Illinois Center for Health Statistics
Notes: Intercensal Estimates: 1991-1999, 2001
children 0-6 was used to estimate intercensal and postcensal year estimates for 0
Illinois Morbidity and Mortality Bulletin
Figure 3. Testing Rates for Childhood Blood Lead Prevalence in Illinois and Chicago, 1996
Illinois Department of Public Health, Lead Program Surveillance Database, 1996-2012;
Department of Public Health, Illinois Center for Health Statistics
1999, 2001-2009; Postcensal Estimates: 2011 and 2012; Census year distribution for
6 was used to estimate intercensal and postcensal year estimates for 0-6 years population
Illinois Morbidity and Mortality Bulletin
Vol. 1, Issue 2 Page 26
Figure 3. Testing Rates for Childhood Blood Lead Prevalence in Illinois and Chicago, 1996-2012
U.S. Census Bureau; Illinois
2009; Postcensal Estimates: 2011 and 2012; Census year distribution for
6 years population
Illinois Morbidity and Mortality Bulletin
September 2015 Vol. 1, Issue 2 Page 27
Figure 4. Childhood Blood Lead Prevalence Rates for Illinois and Chicago by Year, 1996-2012
Source: Illinois Department of Public Health, Lead Program Surveillance Database, 1996-2012.
Note: U.S. prevalence added here only to show the trend in lead poisoning decline with time based on children less than 6 years of age. Be cautious in relating the U.S.
prevalence rate with the Illinois prevalence rate.
Illinois Morbidity and Mortality Bulletin
September 2015
Figure 5. Blood Lead Prevalence in Illinois and Chicago Children by Race/Ethnicity, 1996
Source: Illinois Department of Public Health, Lead Program Surveillance Database
Note: Other races were too few to be reported. Lead prevalence between 2001
Illinois Morbidity and Mortality Bulletin
Figure 5. Blood Lead Prevalence in Illinois and Chicago Children by Race/Ethnicity, 1996-2012
Illinois Department of Public Health, Lead Program Surveillance Database, 1996-2012.
. Lead prevalence between 2001-2002 in Chicago was not included for White children due to very few test records.
Vol. 1, Issue 2 Page 28
was not included for White children due to very few test records.
Illinois Morbidity and Mortality Bulletin
September 2015 Vol. 1, Issue 2 Page 29
Figure 6. Blood Lead Prevalence in Illinois and Chicago Children by Gender and Year, 1996-2012
Source: Illinois Department of Public Health, Lead Program Surveillance Database, 1996-2012.
Illinois Morbidity and Mortality Bulletin
September 2015 Vol. 1, Issue 2 Page 30
Figure 7. Blood Lead Prevalence Rates by Medicaid Status and Year, 1996-2012
Sources: Illinois Department of Public Health, Lead Program Surveillance Database, 1996-2012; the Department of
Healthcare and Family Services, Enterprise Data Warehouse.
Illinois Morbidity and Mortality Bulletin
September 2015 Vol. 1, Issue 2 Page 31
Figure 8a. Decrease in Illinois Childhood Blood Lead Prevalence by County by Year
1996 2001
National (CDC) lead prevalence rate was 3.0 percent and Illinois was 7.9 percent
2007
National (CDC) lead prevalence rate was 0.9
percent and Illinois was 3.2 percent
2012
National (CDC) lead prevalence rate was 0.6
percent and Illinois was 1.3 percent
Source: Illinois Department of Public Health, Lead Program Surveillance Database, 1996-2012.
Illinois Morbidity and Mortality Bulletin
September 2015 Vol. 1, Issue 2 Page 32
Figure 8b. Decrease in Chicago Childhood Blood Lead Prevalence by Community Areas by Year
National (CDC) lead prevalence rate was 3.0 percent Illinois was 7.9 percent and Chicago was 12.5 percent
National (CDC) lead prevalence rate was 0.9 percent; Illinois
was 3.2 percent and Chicago was 2.5 percent
National (CDC) lead prevalence rate was 0.6 percent
Illinois was 1.3 percent and Chicago was 1.1 percent
Source: Illinois Department of Public Health, Lead Program Surveillance Database, 1996-2012 and the Chicago Department of
Public Health's Lead Poisoning Prevention Program.
76
51
25
28
2
55
61
7
70
49
6
30
24
10
56
8
15
19
4
71
17
53
23
54
22
3
69
66
46
75
16
72
12
29
67
5
68
31
52
44
65
43
73
1
74
58
64
1311
63
50
60
42
21
57
27
14
33
48
77
9
38
35
41
32
40
59
26
45
62
20
39
18
34
37
47
36
Community Area Name 1. ROGERS PARK 40. WASHINGTON PARK 2. WEST RIDGE 41. HYDE PARK 3. UPTOWN 42. WOODLAWN 4. LINCOLN SQUARE 43. SOUTH SHORE 5. NORTH CENTER 44. CHATHAM 6. LAKE VIEW 45. AVALON PARK 7. LINCOLN PARK 46. SOUTH CHICAGO 8. NEAR NORTH SIDE 47. BURNSIDE 9. EDISON PARK 48. CALUMET HEIGHTS 10. NORWOOD PARK 49. ROSELAND 11. JEFFERSON PARK 50. PULLMAN
12. FOREST GLEN 51. SOUTH DEERING 13. NORTH PARK 52. EAST SIDE 14. ALBANY PARK 53. WEST PULLMAN 15. PORTAGE PARK 54. RIVERDALE 16. IRVING PARK 55. HEGEWISCH 17. DUNNING 56. GARFIELD RIDGE 18. MONTCLARE 57. ARCHER HEIGHTS 19. BELMONT CRAGIN 58. BRIGHTON PARK 20. HERMOSA 59. MCKINLEY PARK 21. AVONDALE 60. BRIDGEPORT 22. LOGAN SQUARE 61. NEW CITY 23. HUMBOLDT PARK 62. WEST ELSDON 24. WEST TOWN 63. GAGE PARK 25. AUSTIN 64. CLEARING 26. WEST GARFIELD PARK 65. WEST LAWN
27. EAST GARFIELD PARK 66. CHICAGO LAWN 28. NEAR WEST SIDE 67. WEST ENGLEWOOD 29. NORTH LAWNDALE 68. ENGLEWOOD 30. SOUTH LAWNDALE 69. GREATER GRAND CROSSING 31. LOWER WEST SIDE 70. ASHBURN 32. LOOP 71. AUBURN GRESHAM 33. NEAR SOUTH SIDE 72. BEVERLY 34. ARMOUR SQUARE 73. WASHINGTON HEIGHTS 35. DOUGLAS 74. MOUNT GREENWOOD 36. OAKLAND 75. MORGAN PARK 37. FULLER PARK 76. OHARE 38. GRAND BOULEVARD 77. EDGEWATER 39. KENWOOD
1996
Children with ElevatedBlood Lead Levels (%)
0.0-1.1
1.2-1.7
1.8 and above
76
51
25
28
2
55
61
7
70
49
6
30
24
10
56
8
15
19
4
71
17
53
23
54
22
3
69
66
46
75
16
72
12
29
67
5
68
31
52
44
65
43
73
1
74
58
64
1311
63
50
60
42
21
57
27
14
33
48
77
9
38
35
41
32
40
59
26
45
62
20
39
18
34
37
47
36
Community Area Name 1. ROGERS PARK 40. WASHINGTON PARK 2. WEST RIDGE 41. HYDE PARK 3. UPTOWN 42. WOODLAWN 4. LINCOLN SQUARE 43. SOUTH SHORE 5. NORTH CENTER 44. CHATHAM 6. LAKE VIEW 45. AVALON PARK 7. LINCOLN PARK 46. SOUTH CHICAGO 8. NEAR NORTH SIDE 47. BURNSIDE 9. EDISON PARK 48. CALUMET HEIGHTS 10. NORWOOD PARK 49. ROSELAND 11. JEFFERSON PARK 50. PULLMAN 12. FOREST GLEN 51. SOUTH DEERING 13. NORTH PARK 52. EAST SIDE 14. ALBANY PARK 53. WEST PULLMAN 15. PORTAGE PARK 54. RIVERDALE 16. IRVING PARK 55. HEGEWISCH 17. DUNNING 56. GARFIELD RIDGE 18. MONTCLARE 57. ARCHER HEIGHTS 19. BELMONT CRAGIN 58. BRIGHTON PARK 20. HERMOSA 59. MCKINLEY PARK 21. AVONDALE 60. BRIDGEPORT 22. LOGAN SQUARE 61. NEW CITY 23. HUMBOLDT PARK 62. WEST ELSDON 24. WEST TOWN 63. GAGE PARK 25. AUSTIN 64. CLEARING 26. WEST GARFIELD PARK 65. WEST LAWN 27. EAST GARFIELD PARK 66. CHICAGO LAWN 28. NEAR WEST SIDE 67. WEST ENGLEWOOD 29. NORTH LAWNDALE 68. ENGLEWOOD 30. SOUTH LAWNDALE 69. GREATER GRAND CROSSING 31. LOWER WEST SIDE 70. ASHBURN 32. LOOP 71. AUBURN GRESHAM 33. NEAR SOUTH SIDE 72. BEVERLY 34. ARMOUR SQUARE 73. WASHINGTON HEIGHTS 35. DOUGLAS 74. MOUNT GREENWOOD 36. OAKLAND 75. MORGAN PARK 37. FULLER PARK 76. OHARE 38. GRAND BOULEVARD 77. EDGEWATER 39. KENWOOD
2001
Children with ElevatedBlood Lead Levels (%)
lohi
0.0-1.1
1.2-1.7
1.8 and above
National(CDC) lead prevalence rate was 3.0
76
51
25
28
2
55
61
7
70
49
6
30
24
10
56
8
15
19
4
71
17
53
23
54
22
3
69
66
46
75
16
72
12
29
67
5
68
31
52
44
65
43
73
1
74
58
64
1311
63
50
60
42
21
57
27
14
33
48
77
9
38
35
41
32
40
59
26
45
62
20
39
18
34
37
47
36
Community Area Name 1. ROGERS PARK 40. WASHINGTON PARK 2. WEST RIDGE 41. HYDE PARK 3. UPTOWN 42. WOODLAWN 4. LINCOLN SQUARE 43. SOUTH SHORE 5. NORTH CENTER 44. CHATHAM 6. LAKE VIEW 45. AVALON PARK 7. LINCOLN PARK 46. SOUTH CHICAGO 8. NEAR NORTH SIDE 47. BURNSIDE 9. EDISON PARK 48. CALUMET HEIGHTS 10. NORWOOD PARK 49. ROSELAND 11. JEFFERSON PARK 50. PULLMAN 12. FOREST GLEN 51. SOUTH DEERING 13. NORTH PARK 52. EAST SIDE 14. ALBANY PARK 53. WEST PULLMAN 15. PORTAGE PARK 54. RIVERDALE 16. IRVING PARK 55. HEGEWISCH 17. DUNNING 56. GARFIELD RIDGE 18. MONTCLARE 57. ARCHER HEIGHTS 19. BELMONT CRAGIN 58. BRIGHTON PARK 20. HERMOSA 59. MCKINLEY PARK 21. AVONDALE 60. BRIDGEPORT 22. LOGAN SQUARE 61. NEW CITY 23. HUMBOLDT PARK 62. WEST ELSDON 24. WEST TOWN 63. GAGE PARK 25. AUSTIN 64. CLEARING 26. WEST GARFIELD PARK 65. WEST LAWN 27. EAST GARFIELD PARK 66. CHICAGO LAWN 28. NEAR WEST SIDE 67. WEST ENGLEWOOD 29. NORTH LAWNDALE 68. ENGLEWOOD 30. SOUTH LAWNDALE 69. GREATER GRAND CROSSING 31. LOWER WEST SIDE 70. ASHBURN 32. LOOP 71. AUBURN GRESHAM 33. NEAR SOUTH SIDE 72. BEVERLY 34. ARMOUR SQUARE 73. WASHINGTON HEIGHTS 35. DOUGLAS 74. MOUNT GREENWOOD 36. OAKLAND 75. MORGAN PARK 37. FULLER PARK 76. OHARE 38. GRAND BOULEVARD 77. EDGEWATER 39. KENWOOD
2007
National(CDC) lead prevalence rate was 0.9
Children with ElevatedBlood Lead Levels (%)
0.0-1.1
1.2-1.7
1.8 and above
76
51
25
28
2
55
61
7
70
49
6
30
24
10
56
8
15
19
4
71
17
53
23
54
22
3
69
66
46
75
16
72
12
29
67
5
68
31
52
44
65
43
73
1
74
58
64
1311
63
50
60
42
21
57
27
14
33
48
77
9
38
35
41
32
40
59
26
45
62
20
39
18
34
37
47
36
Community Area Name 1. ROGERS PARK 40. WASHINGTON PARK
2. WEST RIDGE 41. HYDE PARK 3. UPTOWN 42. WOODLAWN 4. LINCOLN SQUARE 43. SOUTH SHORE 5. NORTH CENTER 44. CHATHAM 6. LAKE VIEW 45. AVALON PARK 7. LINCOLN PARK 46. SOUTH CHICAGO 8. NEAR NORTH SIDE 47. BURNSIDE 9. EDISON PARK 48. CALUMET HEIGHTS 10. NORWOOD PARK 49. ROSELAND 11. JEFFERSON PARK 50. PULLMAN 12. FOREST GLEN 51. SOUTH DEERING 13. NORTH PARK 52. EAST SIDE 14. ALBANY PARK 53. WEST PULLMAN 15. PORTAGE PARK 54. RIVERDALE 16. IRVING PARK 55. HEGEWISCH
21. AVONDALE 60. BRIDGEPORT 22. LOGAN SQUARE 61. NEW CITY 23. HUMBOLDT PARK 62. WEST ELSDON 24. WEST TOWN 63. GAGE PARK 25. AUSTIN 64. CLEARING 26. WEST GARFIELD PARK 65. WEST LAWN 27. EAST GARFIELD PARK 66. CHICAGO LAWN 28. NEAR WEST SIDE 67. WEST ENGLEWOOD 29. NORTH LAWNDALE 68. ENGLEWOOD 30. SOUTH LAWNDALE 69. GREATER GRAND CROSSING 31. LOWER WEST SIDE 70. ASHBURN 32. LOOP 71. AUBURN GRESHAM 33. NEAR SOUTH SIDE 72. BEVERLY 34. ARMOUR SQUARE 73. WASHINGTON HEIGHTS 35. DOUGLAS 74. MOUNT GREENWOOD
36. OAKLAND 75. MORGAN PARK 37. FULLER PARK 76. OHARE 38. GRAND BOULEVARD 77. EDGEWATER 39. KENWOOD
2012
National(CDC) lead prevalence rate was 0.6
Children with ElevatedBlood Lead Levels (%)
0.0-1.1
1.2-1.7
1.8 and above
Illinois Morbidity and Mortality Bulletin
September 2015
Figure 9. Geometric Mean Blood Lead
Source: Illinois Department of Public Health, Lead Program Surveillance Database
Illinois Morbidity and Mortality Bulletin
Vol. 1, Issue 2 Page
Mean Blood Lead Levels for Illinois and Chicago Children by Year, 1996
Illinois Department of Public Health, Lead Program Surveillance Database, 1996-2012.