MENDS-on-FHIR: Leveraging the OMOP common data model and FHIR standards for national chronic disease surveillance.

Many chronic conditions, such as hypertension, obesity, and diabetes are becoming more prevalent, especially in high-risk individuals, such as minorities and low-income patients. Public health surveillance networks measure the presence of specific conditions repeatedly over time, seeking to detect changes in the amount of a disease conditions so that public health officials can implement new early-prevention programs or evaluate the impact of an existing prevention program. Data stored in electronic health records (EHRs) could be used to measure the presence of health conditions, but significant technical barriers make current methods for data extraction laborious and costly. HL7 BULK FHIR is a new data standard that is required to be available in all commercial EHR systems in the United States. We examined the use of BULK FHIR to provide EHR data to an existing public health surveillance network called MENDS. We found that HL7 BULK FHIR can provide the necessary data elements for MENDS in a standardized format. Using HL7 BULK FHIR could significantly reduce barriers to data for public health surveillance needs, enabling public health officials to expand the diversity of locations and patient populations being monitored.