NYC Macroscope Paper Series Abstracts
This set of three eGEMs abstracts shows the complete journey of the NYC Macroscope methods, validations, and findings, and can serve as a model of innovative population health surveillance for other cities and health departments.
As New York City’s first electronic health record (EHR) surveillance system, NYC Macroscope complements traditional methods of monitoring the health of a population, such as statistically representative telephone and in-person surveys. While traditional methods are scientifically rigorous and have enduring important qualities, they are also labor intensive and can take a long time to yield results.
In contrast, EHRs are electronic versions of a patient’s medical records maintained by health care providers at patient visits. Data within these records can be more easily available and summarized in a timely manner.
The authors compared 2013 results from NYC Macroscope to two different traditional surveys: the 2013-14 NYC Health and Nutrition Examination Survey (NYC HANES) and the 2013 Community Health Survey. They found that NYC Macroscope prevalence estimates for obesity, hypertension, smoking, and diabetes were comparable to the survey results. However, the treatment and control measures for diabetes, hypertension and high cholesterol were not.
Despite that variation, findings confirm that a carefully constructed EHR-based surveillance system can generate prevalence estimates comparable to those from gold-standard examination surveys for certain conditions and risk factors.
This set of three eGEMs papers shows the complete journey of the NYC Macroscope methods, validations, and findings:
- The first paper, “Design of the New York City Macroscope: Innovations in Population Health Surveillance Using Electronic Health Records,” describes the governance and technical infrastructures that serve as the foundation for the NYC Macroscope.
- The second paper, “Can Electronic Health Records Be Used for Population Health Surveillance? Validating Population Health Metrics Against Established Survey Data,” addresses concerns related to sampling bias and data quality. The paper also describes the methods the authors used to evaluate the validity and robustness of NYC Macroscope prevalence estimates; presents validation results for estimates of obesity, smoking, depression, and influenza vaccination; and discusses the implications of the findings for NYC and for other jurisdictions looking to begin similar work.
- The final paper, “Monitoring Prevalence, Treatment, and Control of Metabolic Conditions in New York City Adults Using 2013 Primary Care Electronic Health Records: A Surveillance Validation Study,” presents validation findings for metabolic indicators (hypertension, hyperlipidemia, diabetes).
NYC Macroscope and NYC HANES were initiatives designed and implemented by a team of researchers at the NYC Department of Health and Mental Hygiene, in partnership with researchers at the CUNY School of Public Health (who are now at the NYU School of Medicine).