BACKGROUND The increasing adoption of electronic health record (EHR) systems enables automated, large scale, and meaningful analysis of regional population health. We explored how EHR systems could inform surveillance of trauma-related emergency department visits arising from seasonal, holiday-related, and rare environmental events. METHODS We analyzed temporal variation in diagnosis codes over 24 years of trauma visit data at the three hospitals in the University of Washington Medicine system in Seattle, Washington, USA. We identified seasons and days in which specific codes and categories of codes were statistically enriched, meaning that a significantly greater than average proportion of trauma visits included a given diagnosis code during that time period. RESULTS We confirmed known seasonal patterns in emergency department visits for trauma. As expected, cold weather-related incidents (e.g. frostbite, snowboarding injury) were enriched in the winter, whereas fair weather-related incidents (e.g. bug bites, boating accidents, bicycle accidents) were enriched in the spring and summer. Our analysis of specific days of the year found that holidays were enriched for alcohol poisoning, assaults, and firework accidents. We also detected one time regional events such as the 2001 Nisqually earthquake and the 2006 Hanukkah Eve Windstorm. CONCLUSIONS Though EHR systems were developed to prioritize operational rather than analytic priorities and have consequent limitations for surveillance, our EHR enrichment analysis nonetheless re-identified expected temporal population health patterns. EHRs are potentially a valuable source of information to inform public health policy, both in retrospective analysis and in a surveillance capacity.

中文翻译：

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评估电子健康记录的二次使用，以检测与创伤性伤害和中毒相关的季节性、假日相关和罕见事件。


背景技术电子健康记录（EHR）系统的日益普及使得能够对区域人口健康进行自动化、大规模且有意义的分析。我们探讨了 EHR 系统如何为因季节性、假日相关和罕见环境事件而引起的创伤相关急诊就诊的监测提供信息。方法 我们分析了美国华盛顿州西雅图华盛顿大学医学系统三家医院 24 年的创伤就诊数据中诊断代码的时间变化。我们确定了特定代码和代码类别在统计上丰富的季节和日期，这意味着该时间段内包含给定诊断代码的创伤就诊比例明显高于平均水平。结果 我们确认了因创伤而急诊就诊的已知季节性模式。正如预期的那样，与寒冷天气相关的事件（例如冻伤、滑雪受伤）在冬季丰富，而与晴天相关的事件（例如虫咬、划船事故、自行车事故）在春季和夏季丰富。我们对一年中特定日期的分析发现，假期中酒精中毒、袭击和烟花事故的发生频率较高。我们还检测到了一次区域性事件，例如 2001 年尼斯夸利地震和 2006 年光明节前夕风暴。结论 尽管 EHR 系统的开发是为了优先考虑操作优先事项而不是分析优先事项，并且因此对监测产生限制，但我们的 EHR 丰富分析仍然重新确定了预期的人口健康时间模式。无论是在回顾性分析还是在监测能力方面，电子病历都可能是为公共卫生政策提供信息的宝贵信息来源。