Syndromic surveillance systems collect and analyze diagnostician and nonclinical disease indicators, drawing on preexisting electronic data that can be found in systems such as electronic health records, school absenteeism records, and pharmacy systems. Case Study 13: Implementing a Syndromic Surveillance System 465 These surveillance systems are intended to identify specific symptoms within a population that may indicate a public health event or emergency. For example, the data being collected by a surveillance system might reveal a sharp increase in diarrhea in a community and that could signal an outbreak of an infectious disease. The infectious disease epidemiology section of a state’s public health agency has been given the task of implementing the Early Aberration Reporting System of the Centers for Disease Control and Prevention. The agency views this system as significantly improving its ability to monitor and respond to potential problematic bioterrorism, food poisoning, and infectious disease outbreaks. The implementation of the system is also seen as a vehicle for improving collaboration between the agency, health care providers, information technology vendors, researchers, and the business community.
Information Systems Challenge The agency and its infectious disease epidemiology section face several major challenges. First, the necessary data must be collected largely from hospitals and in particular emergency rooms. Developing and supporting necessary interfaces to the applications in a large number of hospitals is very challenging. These hospitals have different application vendors, diverse data standards, and uneven willingness to divert IT staff and budget to the implementation of these interfaces. To help address this challenge, the section will acquire a commercial package or build the needed software to ease the integration challenge. In addition, the section will provide each hospital with information it can use to assess its own mix of patients and their presenting problems. The agency is also contemplating the development of regulations that would require the hospitals to report the necessary data. Second, the system must be designed so that patient privacy is protected and the system is secure. Third, the implementation and support of the system will be funded initially through federal grants. The agency will need to develop strategies for ensuring the financial sustainability of the application and related analysis capabilities should federal funding end. Fourth, the agency needs to ensure that the section has the staff and tools necessary to appropriately analyze the data. Distinguishing true problems from the “noise” of a normal increase in colds during the winter, for example, can be very difficult. The agency could damage the public’s confidence in the system if it overreacts or under reacts to the data it collects.
1. What is a syndrome Surveillance System?
2. If you were the head of the agency’s epidemiology section how would you address the four challenges described here?
3. Which of the challenges is the most important to address? Why?
