EHC Project C2 Description_EHR and Cancer.docx

Project C2 Description

CDC-RFA-EH20-2005 – Supplemental NOFO Strengthening environmental health capacity (EHC) for detecting, preventing, and controlling environmental health hazards through data-driven and evidence-based approaches

GENERAL INFORMATION

Component B: Programs and services – strengthens capacity of EH programs and services in areas such as private drinking water, recreational water, rodent control, and food safety.

Component C: Priority and emerging hazards and issues – strengthens capacity for addressing specific priority EH hazards or issues such as harmful algal blooms or environmental issues related to homelessness.

Overview (100 word limit):

This pilot effort aims to inform the feasibility of electronic health records (EHRs) as a source of cancer and environmental risk factor data available to state and local public health partners to better evaluate concerns of elevated cancer rates. Population based cancer registries area critical component in identifying unusual patterns of cancer, but these data are necessarily delayed by several years due to reporting requirements. Additionally, information reflective of potential environmental exposures is not reported routinely. Identifying and utilizing novel and existing data sources offers an opportunity for obtaining more current and complete data relative to potential risk factors.

PROJECT DETAILS

The purpose of this project is to determine the feasibility and utility of EHRs to provide access to more current data with a minimal delay between cancer diagnosis and reporting, to serve as a potential source of environmental risk factor data, and to provide more complete data relative to sociodemographic factors to better identify inequities. With access to enhanced data sources it is anticipated that health departments and environmental health programs will be better prepared to identify and address community concerns about cancer and the environment; with particular interest in identifying unusual patterns in pediatric populations and addressing issues of health equity.

Expected outcomes:

1. Established data sharing relationships and acquired EHR data available through the most current month/year.

2. EHR data are used to describe relationships between environmental exposures and cancer, in particular pediatric cancers, and unusual patterns of cancer or areas of concern are identified.

3. Health department and environmental health programs will have increased capacity and access to novel data resources to address community concerns about adverse health outcomes and hazardous environmental exposures, with particular interest in cancer and pediatric cancers.

STRATEGIES AND ACTIVITIES

Proposed activities (800 word limit) Activities should address the exploration and use of EHR data for investigating unusual occurrences of cancer, particularly pediatric cancer. Recipients should demonstrate access to, or acquisition of, EHR data, including state cancer registry data, to be used to assess the completeness of EHR data. Recipients will characterize availability of environmental exposure data in the EHR system, the utility of such data to identify cancer clusters and potential environmental exposures, and how these data may be used to address issues of health equity.

Strategy 1: Strengthen EH data use and informatics capacity

Activity 1a: Identify and access EHR data sources within jurisdictions or states.

Activity 1b: Assess completeness of EHR cancer data relative to cancer registry data within the same geographical region of the EHR system catchment area.

Activity 1c: Explore availability, completeness, and utility of potential environmental exposure data in the EHR system.

Strategy 2: Identify, prevent, and control EH hazards

Activity 2a: Utilize environmental data in combination with EHR data to aid investigations of environmental exposure risks and cancer.

Activity 2b: Analyze the EHR data to identify unusual patterns of cancer and associated environmental exposures.

Activity 2c: Develop educational materials and outreach activities that communicate findings from identification of unusual patterns in order to reduce potential environmental exposures and prevent cancers related to potential environmental exposures.

Strategy 3: Assess EH intervention effectiveness and impact

Activity 3a: Generate recommendations for the use of EHR data in investigations of unusual cancer occurrences.

Activity 3b: Assess and provide evidence of the effectiveness of using EHR data in investigations of unusual cancer occurrences.

Activity 3c: Assess effectiveness of educational materials and outreach activities.

EVALUATION AND PERFORMANCE MEASUREMENT

Strategy 1 activities:

Measure #1: List and describe the existing EHR data sources and the data included in these systems. Characteristics should include, but are not limited to, the number of years of data, the population the EHR data represent (e.g. ambulatory care, hospital admissions, etc.), payer type, and frequency of data updates.

Measure #2: Provide comparison report of the EHR data system and cancer registry data over the same time and geographical region as the EHR system catchment area and describe the strengths and limitations of the EHR data.

Measure #3: List and describe the type of EHR data fields and the content of such fields relative to environmental exposure data.

Measure #4: Description of the strengths and limitations of these data.

Strategy 2 activities:

Measure #1: Number of potential environmental exposures identified.

Measure #2: Percent of target population reached with educational materials and outreach activities.

Strategy 3 activities:

Measure #1: List and describe the feasibility and sustainability of access and analysis of EHR data.

Measure #2: Description of the effectiveness of using EHR data in investigations of unusual cancer occurrences.

COLLABORATIVE WORK

· With other CDC programs and CDC-funded organizations: Recipients may be expected to collaborate with different CDC programs and technical staff depending on project EH topic area or function being addressed.

· With organizations not funded by CDC: Based on the applicant’s strategy, potential collaboration, partnerships, and outreach could include work with, but is not limited to, other environmental and public health agencies, non-governmental organizations, and electronic health record data providers. Applicants may have opportunities to request support from non-governmental organizations to assist with equipment and supplies procurement and to assist with other administrative processes.

FUNDING AND BUDGET INSTRUCTIONS

· Estimated total availability of funds: $500,000

· Estimated number of awards given: 2

· Estimated average per award: $250,000

General instructions for use of funds, as applicable (200 word limit):

Funding may support staff time, travel, shipping, printing, contracting for services or products and purchasing supplies, equipment, and electronic medical record data. Contracted services may include but are not limited to collecting, organizing, analyzing and/or interpreting electronic health record data; conducting assessments; and evaluating services or processes. Future year funding is not guaranteed.

References and additional guidance (if applicable)

References: N/A