The GP infection barometer: Protocol of a real-time syndromic surveillance of multiple infectious diseases in primary care using electronic health records

Nathalie Bossuyt, Mélanie Nahimana, Floriane Rouvez, Sarah Moreels, Robrecht De Schreye, Sherihane Bensemmane

Keywords: syndromic surveillance; electronic health records, infection, primary care

Background:

Traditional questionnaire-based surveillance methods face several challenges, including burdensome participation for general practitioners (GPs), limited networks, delays in reporting, and the ability to monitor only a small number of infections. In contrast, electronic health records (EHRs) based surveillance offers significant advantages. By automatically extracting data from EHRs, it eliminates registration burdens on GPs and enables rapid recruitment of a large number of participants. This approach allows for real-time data collection, enabling simultaneous monitoring of multiple types of infections. The nationwide COVID-19 GP barometer proved feasibility and usefulness of this type of syndromic surveillance.

Research questions:

The GP Infection Barometer aims to enhance syndromic infectious disease surveillance by using electronic health records (EHRs) in primary care settings, targeting episodes of selected acute respiratory infections, vaccine-preventable infections, sexually transmitted infections, gastrointestinal infections, and other infections, through the automatic extraction of aggregated diagnoses from the EHRs of general practices.

Method:

All labeled software packages for general practitioners in Belgium can implement the extraction tool. The national health institute Sciensano selected the diagnostic ICPC-2 codes and wrote the algorithms for data extraction from the GPs’ EHRs for the participating softwares.
The software package of participating GPs conducts a daily clinical audit within the practices’ EHRs, aggregating new diagnoses across specified age groups. Data is securely transmitted to Healthdata, Belgium's national health registry platform, for analysis by epidemiologists at Sciensano.

Results:

Based on the obtained data, aggregated time series and visualisations will be made publicly available weekly and shared with policy actors. Each participating GP practice receives weekly a summary of its own epidemiological data.

Conclusions:

Implementing the GP Infection Barometer supports health authorities in conducting infectious disease prevention and control and managing health crises, and provides general practitioners with insights into the impact of infectious diseases on their practice.

Points for discussion:

Can extraction of diagnostic data from EHR be implemented as a routine syndromic surveillance tool?

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