By: Christopher Parrella, Esq., CPC, CHC, CPCO
Parrella Health Law, Boston, MA
A Health Care Provider Defense and Compliance Firm

Did you know that one of the biggest environmental health crises in recent U.S. history was first brought to light by a doctor sifting through electronic medical records? In 2015, Dr. Mona Hanna-Attisha, a pediatrician at Hurley Medical Center in Flint, Michigan, suspected something was terribly wrong with her city’s water. When officials wouldn’t provide data on lead levels, she turned to an unlikely hero: her hospital’s Epic electronic medical record (EMR) system. What she discovered through an anonymized EMR data search would shock the nation and spur life-saving action.

A Pediatrician’s Hunch and a Data Dive

In April 2014, the city of Flint switched its water supply from Detroit’s treated water to the Flint River. Almost immediately, residents complained of foul, discolored water, but for months, authorities insisted it was safe. Dr. Hanna-Attisha, hearing concerns from parents and even a tip from a friend at the EPA, grew worried that children were being exposed to lead from the water. Lead is a silent toxin, especially dangerous to young children’s developing brains – yet its effects aren’t obvious without testing.

Blocked by state and county agencies who refused to share blood lead data, Dr. Hanna-Attisha took matters into her own hands. She queried Hurley Medical Center’s Epic EMR database for blood lead tests of local children. Because the hospital is the region’s primary pediatric center, it held county-wide lab records of children’s lead levels – data that could be examined without names or identifiers. In essence, the EMR allowed Dr. Hanna-Attisha to perform a rapid, privacy-safe analysis of Flint’s kids by time and location, something “not usually afforded to clinicians” through standard public health surveillance.

“Epic is one of the unsung heroes of the Flint water crisis,” Dr. Hanna-Attisha later said, noting how the EMR provided critical data when public health agencies failed. In her memoir, she even wrote that without this electronic data, “this kind of study would have taken months, possibly years… reviewing paper chart by paper chart by hand.” In other words, the hospital’s EMR transformed what would have been a tedious manual record review into an overnight data dive.

Startling Findings: Lead Levels Spiked

When Dr. Hanna-Attisha and her team analyzed the EMR data, the results were alarming. Comparing children’s blood tests before vs. after the April 2014 water switch, they found a clear spike in lead poisoning. Key findings included:

• Citywide doubling of elevated lead levels:
  Before the switch, about 2.4% of young children tested had blood lead levels at or above the CDC’s concern threshold (5 µg/dL). After the switch, that number jumped to 4.9% – roughly double. This meant significantly more kids were showing dangerous levels of lead in their blood than before.
• Dramatic increases in hard-hit neighborhoods:
  In some parts of Flint, the surge was even worse. For areas with the most lead in the water, the proportion of children with elevated lead leapt from 4.0% to 10.6% after the switch, more than doubling the pre-switch rate. Certain predominantly affected ZIP codes (like 48503 and 48504) saw the highest concentrations of children with high lead levels. These were the neighborhoods with older pipes and greater poverty, which were hit hardest by the contaminated water.
• Confirmation of a brewing crisis:
  The data proved that Flint’s children were being poisoned by their tap water. The timing correlated perfectly with the change in water source. In short, the EMR data drew a stark before-and-after picture: once Flint River water began flowing through corrosive pipes, kids’ blood lead levels rose sharply, especially in the most vulnerable areas.

Dr. Hanna-Attisha’s EMR-backed study transformed an anecdotal concern into hard evidence. It showed that Flint’s water was not just discolored – it was biologically harming children. This was the smoking gun needed to make officials and the public take notice.

From Data to National Action

Armed with these facts and figures, Dr. Hanna-Attisha knew she had to sound the alarm. She initially presented her findings to local and state officials – even meeting with Flint’s mayor – but was dismissed and disbelieved. Undeterred, she decided to go public. In late September 2015, alongside other physicians and scientists, she held a press conference to announce the EMR study results. This bold move put Flint’s water crisis in the spotlight for the first time.

The “Did you know?” moment had arrived: a local pediatrician revealed that Flint’s kids were in danger, using nothing more than hospital data and her determination. Media outlets nationwide picked up the story, and public outrage erupted. Under intense national pressure, officials could no longer wave away the problem. Within weeks, the state of Michigan acknowledged the crisis; Flint was switched back to a safer water source (Detroit’s water system) and a state of emergency was declared. Dr. Hanna-Attisha’s evidence had finally forced action to protect Flint’s children.

This chain of events underscores how swiftly things moved once the data came out. What if she hadn’t mined those electronic records? It’s chilling to imagine: the lead exposure might have continued unchecked far longer, and countless more children could have been harmed. By leveraging the EMR, Dr. Hanna-Attisha cut through months of denial and inertia. As Epic’s own summary put it, her discovery “launched Flint into the national media spotlight,” uncovering years of official inaction.

Big Data, Big Picture: A New Era for Public Health Monitoring

The Flint saga highlights a powerful new model for public health. Anonymized EMR data – essentially big data from healthcare – can be a game-changer in spotting community health threats. In Dr. Hanna-Attisha’s words, electronic health records can “complement surveillance systems” as a creative way to identify high-risk areas and emerging crises. In the past, doctors relied on health departments to alert them to trends like lead poisoning. Now, clinicians can proactively query their own aggregated patient data to uncover patterns in real time.

What happened in Flint is inspiring hospitals and health systems everywhere to think bigger about data. Large healthcare providers (like Epic Systems) have since built tools to leverage de-identified patient data on a massive scale. Researchers can use this trove of information to detect public health trends in weeks rather than years. Imagine being able to spot a spike in asthma attacks in a certain region, or subtle increases in blood lead levels in various cities, just by running a software query much like Dr. Hanna-Attisha did, but on a national scale. This kind of rapid insight simply wasn’t possible with paper charts and siloed data.

The broader implication: EMRs give us the eyes to see public health dangers that might otherwise remain invisible. From environmental exposures like Flint’s lead-tainted water to outbreaks of disease, healthcare data (used responsibly and in anonymized form) is a potent early-warning system. The Flint case taught healthcare professionals that they can and should harness their EMR data for community health, not just individual patient care.

Conclusion: Data, Advocacy, and Protecting Communities

In the end, a “Did you know” tip, powered by EMR data, helped save a city’s children. Dr. Mona Hanna-Attisha’s work is now taught as a lesson in both pediatrics and public health: vigilance and data can protect communities when official systems fail. By quickly analyzing electronic health records, she uncovered a silent epidemic of lead poisoning and refused to stay quiet about it. Her story brought national attention to the Flint water crisis and spurred reforms, from replacing pipes to creating the Flint Registry (built in Epic) to monitor affected residents going forward.

For healthcare professionals and informed citizens, Flint’s experience is a call to action. Data is powerful, but it takes humans with courage to translate numbers into change. As we develop ever better tools to monitor health through anonymized EMR data, we must also be ready to act on what the data tells us. The next public health crisis could be unfolding quietly right now – but if we ask the right questions of our data, we’ll be equipped to raise the alarm, just as a determined doctor in Flint did when she realized something was wrong with the water.

Did you know? Now you do and this knowledge is helping build a safer, healthier future for all our communities.

Sources:

• Hanna-Attisha M. et al., American Journal of Public Health (2016) Hurley Medical Center study on Flint blood lead levels
• Epic Systems, “Using Epic to Uncover the Flint Water Crisis” Dr. Hanna-Attisha’s account of leveraging EMR data
• FierceHealthcare, Lead exposure ‘silent epidemic’ on Epic’s data (Cosmos) and Dr. Hanna-Attisha’s perspective
• Becker’s Hospital Review summary of Dr. Hanna-Attisha’s NYT op-ed on confronting the Flint crisis

Parrella Health Law is a boutique healthcare defense and compliance firm based in Boston led by veteran attorney Christopher A. Parrella. With nearly 30 years of experience, the firm represents a wide array of provider types. From payer audits and SIU investigations to regulatory compliance, litigation strategy, and overpayment settlements, Parrella Health Law is a go-to partner for providers and professionals navigating complex legal and reimbursement challenges. The firm is known for its direct, strategic approach and unwavering commitment to protecting the rights of providers in an increasingly hostile landscape. For more information about the firm’s services, please visit www.parrellahealthlaw.com or contact Chris directly at cparrella@parrellahealthlaw.com or call 857-328-0382