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Developing a Measles Flagging System within the Electronic Health Record

Published online by Cambridge University Press:  23 June 2026

Jenna Rasmusson
Affiliation:
Mayo Clinic
Priya Sampathkumar
Affiliation:
Mayo Clinic, Rochester, MN
John OHoro
Affiliation:
Mayo Clinic College of Medicine
Jean Barth
Affiliation:
Mayo Clinic
Alyssa Olson
Affiliation:
Mayo Clinic
Ben Nelson
Affiliation:
Mayo Clinic
Rebecca Faller
Affiliation:
Mayo Clinic
Leah Siple
Affiliation:
Mayo Clinic

Abstract

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Background: In 2025, 50 measles outbreaks drove 87% of confirmed cases reported in the United States. As a highly infectious virus with an estimated R ranging from 12-18, we sought rapidly scalable and implementable measles preparedness measures for our facilities. Methods: The electronic health record (EHR) has flags that can be placed on patient records to denote the presence of, or concern for, active, transmissible infections. These flags are highly visible in the EHR and represent a good usability heuristic as front line providers are already trained to look for this information. Infection Prevention and Control (IPAC) worked with nursing informatics to develop measles-specific flags for suspected, confirmed and exposed patients in the EHR, expanding flagging functionality in preparation for potential measles cases and exposures. The flagging was tied to registry functionality to allow for tracking of exposed and confirmed cases longitudinally for supporting IPAC investigations in addition to clinical operations. Results: Three different flags were developed in the EHR to address measles. Specific criteria were created for each flag, as shown in Table 1. Table 1: Attached as Image Conclusion: As a highly contagious virus, measles presents unique challenges to healthcare facilities managing both cases and exposures. Measles flags within the EHR can be leveraged to assist facilities with case tracking, exposure management, and infection prevention and control.

A table outlining infection flag guidelines for measles, including how flags are added and removed, and specific flag guidance.

Information

Type
Outbreaks
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America