{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T15:30:22Z","timestamp":1791819022700,"version":"4.3.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T00:00:00Z","timestamp":1642723200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100004956","name":"Minnesota Department of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004956","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR002494"],"award-info":[{"award-number":["UL1TR002494"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Robust disease and syndromic surveillance tools are underdeveloped in the United States, as evidenced by limitations and heterogeneity in sociodemographic data collection throughout the COVID-19 pandemic. To monitor the COVID-19 pandemic in Minnesota, we developed a federated data network in March 2020 using electronic health record (EHR) data from 8 multispecialty health systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>In this serial cross-sectional study, we examined patients of all ages who received a COVID-19 polymerase chain reaction test, had symptoms of a viral illness, or received an influenza test from January 3, 2016, through November 7, 2020. We evaluated COVID-19 testing rates among patients with symptoms of viral illness and percentage positivity among all patients tested, in aggregate and by zip code. We stratified results by patient and area-level characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Cumulative COVID-19 positivity rates were similar for people aged 12-64 years (range, 15.1%-17.6%) but lower for adults aged \u226565 years (range, 9.3%-10.7%). We found notable racial and ethnic disparities in positivity rates early in the pandemic, whereas COVID-19 positivity was similarly elevated across most racial and ethnic groups by the end of 2020. Positivity rates remained substantially higher among Hispanic patients compared with other racial and ethnic groups throughout the study period. We found similar trends across area-level income and rurality, with disparities early in the pandemic converging over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Practice Implications:<\/jats:title>\n                    <jats:p>We rapidly developed a distributed data network across Minnesota to monitor the COVID-19 pandemic. Our findings highlight the utility of using EHR data to monitor the current pandemic as well as future public health priorities. Building partnerships with public health agencies can help ensure data streams are flexible and tailored to meet the changing needs of decision makers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00333549211061317","type":"journal-article","created":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T08:29:28Z","timestamp":1642753768000},"page":"263-271","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Minnesota Electronic Health Record Consortium COVID-19 Project: Informing Pandemic Response Through Statewide Collaboration Using Observational Data"],"prefix":"10.1177","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9581-5223","authenticated-orcid":false,"given":"Tyler N. A.","family":"Winkelman","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, MN, USA"},{"name":"Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen L.","family":"Margolis","sequence":"additional","affiliation":[{"name":"HealthPartners Institute, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Waring","sequence":"additional","affiliation":[{"name":"Essentia Health, Essentia Institute of Health, Duluth, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Bodurtha","sequence":"additional","affiliation":[{"name":"Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"Khazanchi","sequence":"additional","affiliation":[{"name":"Health, Homelessness, and Criminal Justice Lab, Hennepin Healthcare Research Institute, Minneapolis, MN, USA"},{"name":"School of Public Health, University of Minnesota, Minneapolis, MN, USA"},{"name":"College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Gildemeister","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, Saint Paul, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela J.","family":"Mink","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, Saint Paul, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malini","family":"DeSilva","sequence":"additional","affiliation":[{"name":"HealthPartners Institute, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M.","family":"Murray","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Internal Medicine, Hennepin Healthcare, Minneapolis, MN, USA"},{"name":"Berman Center for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nayanjot","family":"Rai","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, University of Minnesota Medical School, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Sonier","sequence":"additional","affiliation":[{"name":"MN Community Measurement, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Neely","sequence":"additional","affiliation":[{"name":"Institute for Clinical Systems Improvement, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven G.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alanna M.","family":"Chamberlain","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn M.","family":"McFarling","sequence":"additional","affiliation":[{"name":"CentraCare, St. Cloud, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. Adams","family":"Dudley","sequence":"additional","affiliation":[{"name":"Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA"},{"name":"Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA"},{"name":"Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul E.","family":"Drawz","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, University of Minnesota Medical School, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,1,21]]},"reference":[{"key":"bibr1-00333549211061317","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6942e1"},{"key":"bibr2-00333549211061317","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.19933"},{"key":"bibr3-00333549211061317","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.20717"},{"key":"bibr4-00333549211061317","doi-asserted-by":"publisher","DOI":"10.14745\/ccdr.v44i01a04"},{"key":"bibr5-00333549211061317","first-page":"254","volume-title":"The Threat of Pandemic Influenza: Are We Ready?","volume":"2005","author":"Institute of Medicine"},{"key":"bibr6-00333549211061317","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2016259"},{"key":"bibr7-00333549211061317","unstructured":"Bollyky TJ, Patrick SM. Improving Pandemic Preparedness: Lessons From COVID-19. Council on Foreign Relations; 2020. Accessed February 7, 2021. https:\/\/www.cfr.org\/report\/pandemic-preparedness-lessons-COVID-19\/findings"},{"key":"bibr8-00333549211061317","unstructured":"Krieger N, Gonsalves G, Bassett MT, Hanage W, Krumholz HM. The fierce urgency of now: closing glaring gaps in US surveillance data on COVID-19. Health Affairs blog. April 14, 2020. Accessed October 6, 2021. https:\/\/www.healthaffairs.org\/do\/10.1377\/hblog20200414.238084\/full"},{"key":"bibr9-00333549211061317","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-031914-122747"},{"key":"bibr10-00333549211061317","doi-asserted-by":"publisher","DOI":"10.1056\/CAT.20.0374"},{"key":"bibr11-00333549211061317","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocaa186"},{"key":"bibr12-00333549211061317","unstructured":"Centers for Medicare & Medicaid Services. Chronic conditions data warehouse: condition categories. Published 2017. Accessed October 6, 2021. https:\/\/ccwdata.org\/web\/guest\/condition-categories"},{"key":"bibr13-00333549211061317","unstructured":"World Health Organization. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision. Volume 2. World Health Organization; 2004. Accessed September 26, 2021. https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/42980\/9241546530_eng.pdf?sequence=1&isAllowed=y"},{"key":"bibr14-00333549211061317","unstructured":"US Census Bureau. American Community Survey 2015-2019 5-year data release. Published December 10, 2020. Accessed February 7, 2021. https:\/\/www.census.gov\/newsroom\/press-kits\/2020\/acs-5-year.html"},{"key":"bibr15-00333549211061317","unstructured":"US Department of Agriculture Economic Research Service. Rural\u2013urban commuting area codes. Published August 17, 2020. Accessed February 7, 2021. https:\/\/www.ers.usda.gov\/data-products\/rural-urban-commuting-area-codes.aspx"},{"key":"bibr16-00333549211061317","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.1585"},{"key":"bibr17-00333549211061317","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2002032"},{"key":"bibr18-00333549211061317","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00547-2020"},{"key":"bibr19-00333549211061317","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.02.018"},{"key":"bibr20-00333549211061317","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0234765"},{"key":"bibr21-00333549211061317","unstructured":"Okun S, McGraw D, Stang P, et al. Making the Case for Continuous Learning From Routinely Collected Data. Institute of Medicine; 2013. Accessed February 7, 2021. https:\/\/nam.edu\/perspectives-2013-making-the-case-for-continuous-learning-from-routinely-collected-data"},{"key":"bibr22-00333549211061317","unstructured":"Wilson J, Bock A. The Benefit of Using Both Claims Data and Electronic Medical Record Data in Health Care Analysis. Optum; 2012."},{"key":"bibr23-00333549211061317","unstructured":"Institute for Clinical Systems Improvement. MN Health Collaborative. Accessed February 7, 2021. https:\/\/www.icsi.org\/programs\/mn-health-collaborative"},{"key":"bibr24-00333549211061317","unstructured":"MN Community Measurement. About us. Accessed February 7, 2021. https:\/\/mncm.org\/about"},{"key":"bibr25-00333549211061317","unstructured":"Centers for Disease Control and Prevention, Agency for Toxic Substances and Disease Registry. CDC\/ATSDR Social Vulnerability Index. Updated April 28, 2021. Accessed September 17, 2021. https:\/\/www.atsdr.cdc.gov\/placeandhealth\/svi\/index.html"}],"updated-by":[{"DOI":"10.1177\/00333549221081562","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T00:00:00Z","timestamp":1644451200000}}],"container-title":["Public Health Reports\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00333549211061317","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00333549211061317","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00333549211061317","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T09:37:36Z","timestamp":1777628256000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00333549211061317"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,21]]},"references-count":25,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1177\/00333549211061317"],"URL":"https:\/\/doi.org\/10.1177\/00333549211061317","relation":{},"ISSN":["0033-3549","1468-2877"],"issn-type":[{"value":"0033-3549","type":"print"},{"value":"1468-2877","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,21]]}}}