Rapid Response to Heat Waves: Using Electronic Health Records to Protect Patients in Near-Real Time
A new study presents a way to quickly identify who is most at risk during heat waves, offering an opportunity to implement protective measures during ongoing climate events.
As summer heat waves grow longer and more dangerous, public health officials often must wait months to learn who and how many people were harmed. A new study published on August 31, 2026 in Nature Health suggests that delays are no longer necessary, offering the opportunity to assess whose health is most at risk, take protective measures, and test whether interventions are working while the heat season is still underway.
The study, led by researchers at the Center for Climate, Health, and the Global Environment at Harvard T.H. Chan School of Public Health (Harvard Chan C-CHANGE) and the Department of Epidemiology at Boston University School of Public Health in collaboration with Truveta, offers a novel approach to extreme heat preparedness.
The research team analyzed 8.1 million emergency department (ED) visits from the summers of 2023–2025, using de-identified electronic health records (EHR) from Truveta member health systems across 19 Eastern U.S. states. They linked daily maximum temperatures to state-level counts of ED visits for all causes, heat-related illnesses, kidney diseases, and psychiatric conditions, and then estimated the increase in ED visits on hotter days and the number of visits during the June and August 2025 heat waves that were attributable to extreme temperatures.
“This is a proof of concept for how near-real time EHR data can be turned into actionable intelligence during an ongoing climate event,” says lead author Amruta Nori-Sarma, deputy director of Harvard Chan C-CHANGE and adjunct assistant professor of environmental health at BUSPH. “If we can see, for example, that older adults with kidney disease are driving a spike in emergency department visits during a heat wave, health systems can respond by increasing outreach, ensuring dialysis access, and staffing up for the next event, well before traditional data sources would typically be available.
“Additionally, while heat related emergency visits might be expected to ease as summer progresses and people adapt, our data show only a modest decline between the June and August heat waves. This has important implications for real-time evaluation of the success of adaptation programs implemented locally. ”
“These two heat waves alone were responsible for over 13,000 excess emergency department visits—a surge that requires real-time visibility and rapid response,” says Mary Willis, senior author and assistant professor of epidemiology and environmental health at BUSPH. “These data underscore the importance of investment in timely population health surveillance and corresponding intervention strategies in the era of increasing extreme heat.”
“As climate-related health threats become more frequent and severe, timely evidence is increasingly essential for effective public health response,” says Brianna Cartwright, director and lead of Truveta Research at Truveta and co-author on the paper. “Timely real-world data allow researchers to rapidly assess the health impacts of extreme heat across diverse populations and geographies, providing a clearer picture of risk. This approach has the potential to transform how we monitor, understand, and respond to climate-related health emergencies.”
Why Rapid-Response Heat Surveillance Is Critical
Traditionally, studies of heat and health have relied on insurance claims data that arrive with long delays, often 6 to 18 months after an extreme heat event. This lag makes it difficult to adjust public health messaging, emergency staffing, or protective programs in time to help the most impacted communities during the same summer.
In contrast, the research team used EHR data available within one week of the ED encounter.
The researchers envision several ways this kind of rapid assessment could strengthen climate and health preparedness: