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Modernize public health surveillance to ease doctors’ reporting burden

Disease surveillance is an essential public health function that requires coordination between health care and public health agencies. The surveillance data is used to monitor, control and prevent diseases. However, authority to require notification of cases of diseases resides with the jurisdiction’s state legislature, causing varying reports.

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These reports have often been created manually or by telephone, mail or fax, which is time consuming and disruptive to workflow, according to an AMA Council on Science and Public Health report whose recommendations were adopted at the 2019 AMA Interim Meeting in San Diego. 

“As state legislatures consider adding to their jurisdiction’s list of diseases and conditions that are required to be reported to public health agencies, they should consult with state and national medical societies and public health agencies to ensure the requirements are based on scientific evidence and will meet the needs of population health,” says the council’s report. 

Public health surveillance has focused on infectious diseases, but expanded to include chronic diseases, occupational and environmental health, hazard surveillance, and injury control. In the future, it is expected that additional diseases and conditions will be explored and added to surveillance. 

“We know that disease surveillance is essential to monitoring, controlling and preventing disease and clinicians play an important role in this process,” said AMA Board Member Willie Underwood III, MD, MPH. “However, submitting data to public health agencies can be burdensome and disruptive to workflows for physicians and other mandatory reporters.

“By modernizing the nation’s public health surveillance systems and implementing electronic case reporting, data will automatically be reported directly through EHR systems in accordance with applicable health care privacy and reporting laws—improving the quality and timeliness of the data while also removing the burden on physicians,” Dr. Underwood added.

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The new policy supports efforts underway to implement electronic case reporting, a process by which reportable conditions are automatically generated from EHR systems to public health agencies for review and action, in accordance with applicable health care privacy and public health reporting laws.

To ensure new disease-reporting requirements are based on scientific evidence and do not add to the burden placed on physicians, the AMA House of Delegates adopted new policies that call on the AMA to:

Recognize public health surveillance as a core public health function that is essential to inform decision making, identify underlying causes and etiologies, and respond to acute, chronic and emerging health threats.

  • Recognize the important role that physicians play in public health surveillance through reporting diseases and conditions to public health authorities.
  • Encourage state legislatures to engage relevant state and national medical specialty societies as well as public health agencies when proposing mandatory reporting requirements to ensure they are based on scientific evidence and meet the needs of population health.
  • Recognize the need for increased federal, state and local funding to modernize our nation’s public health data systems to improve the quality and timeliness of data.
  • Support electronic case reporting, which alleviates the burden of case reporting on physicians through the automatic generation and transmission of case reports from electronic health records to public health agencies for review and action in accordance with applicable health care privacy and public health reporting laws.
  • Share updates with physicians and medical societies on public health surveillance and the progress made toward implementing electronic case reporting.