Hospital electronic health records (EHR) contain important information about patients’ laboratory test results, diagnoses, and treatment. Urine specimens collected from patients as part of routine care may also be used to better understand the drugs to which emergency department (ED) patients have been exposed. The Emergency Department Drug Surveillance (EDDS) system collaborates with hospitals to obtain both quarterly exports of ED patients’ de-identified EHR information and a one-time sample of approximately 150 de-identified urine specimens from each participating hospital site.
The University of Maryland provided CESAR with funding from 2017-2020 to pilot EDDS in 7 hospitals in Maryland. The success of the pilot project led the Office of National Drug Control Policy (ONDCP) to sponsor the subsequent Phase I project (2020-2021), which expanded EDDS to 5 hospitals outside of Maryland. ONDCP funding of Phase II (2021-2022) is enabling the addition of 20 hospitals affiliated with HCA Healthcare.
The EHRs submitted to EDDS contain information on patient urine drug test results, chief complaints, diagnostic codes, and some limited demographic information. The de-identified urine specimens sent to EDDS are re-tested for a panel of 500+ drugs by the EDDS collaborating laboratory.
The quarterly exports of EHR drug test results are used to analyze the trends and patterns in the drugs to which ED patients have been exposed. The expanded re-testing of a sample of patients’ urine specimens enables EDDS to identify emerging drugs and gaps in each hospital’s more limited testing protocols. EDDS findings disseminated on CESAR websites can be used to help inform patient treatment at each hospital, update their testing protocols, and serve as a national drug surveillance system.
EDDS UPDATE Factsheet (October 2020)