J Am Med Inform Assoc 17:217-219 doi:10.1136/jamia.2009.000539
  • Case report

Using electronic health record alerts to provide public health situational awareness to clinicians

  1. Neil Calman1
  1. 1Institute for Family Health, New York, NY, USA
  2. 2Columbia University, New York, NY, USA
  3. 3New York City Department of Health and Mental Hygiene, New York, NY, USA
  4. 4Office of the National Coordinator, Washington, DC, USA
  1. Correspondence to Dr Frances Morrison, 622 West 168th Street, Vanderbilt Clinic, 5th Floor, New York, NY 10032, USA; frances.morrison{at}
  • Received 30 June 2009
  • Accepted 22 December 2009


Alerting providers to public health situations requires timeliness and context-relevance, both lacking in current systems. Incorporating decision support tools into electronic health records may provide a way to deploy public health alerts to clinicians at the point of care. A timely process for responding to Health Alert Network messages sent by the New York City Department of Health and Mental Hygiene was developed by a network of community health centers. Alerts with order sets and recommended actions were created to notify primary care providers of local disease outbreaks. The process, effect, and lessons learned from alerts for Legionella, toxogenic E coli, and measles outbreaks are described. Electronic alerts have the potential to improve management of diseases during an outbreak, including appropriate laboratory testing, management guidance, and diagnostic assistance as well as to enhance bi-directional data exchange between clinical and public health organizations.


  • Funding This work was supported by the Centers for Disease Control and Prevention grant P01 HK000029.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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