Feasibility of Electronic Health Records-based community surveillance of cardiovascular disease: Findings from the Atherosclerosis Risk in Communities Study.

Background: Accurate community surveillance of cardiovascular disease requires hospital record abstraction, which is typically a manual process. The costly and time-intensive nature of manual abstraction precludes its use on a regional or national scale in the US. Whether an efficient system can accurately reproduce traditional community surveillance methods by processing electronic health records (EHRs) has not been established. Objective: We sought to develop and test an EHR-based system to reproduce abstraction and classification procedures for acute myocardial infarction (MI) as defined by the Atherosclerosis Risk in Communities (ARIC) Study. Methods: Records from hospitalizations in 2014 within ARIC community surveillance areas were sampled using a broad set of ICD discharge codes likely to harbor MI. These records were manually abstracted by ARIC study personnel and used to classify MI according to ARIC protocols. We requested EHRs in a unified data structure for the same hospitalizations at 6 hospi...