Zhang Xiaohui

In response to the terrorist attack of September 11, 2001, the NH Department of Health and Human Services (NH DHHS) engaged state and external partners in the design of an early warning surveillance system to support bioterrorism and emergency preparedness. Initially, NH DHHS began collecting four syndrome counts from thirteen hospital Emergency Departments (ED) by fax. Automation began in 2002, when an over the counter (OTC) syndromic surveillance pilot system was implemented by Scientific Technologies Corporation (STC). In 2003-2004 this system, the Syndromic Tracking and Encounter Management System (STEMS), was expanded to include school absentee and occupational health reports. Over time, an internal Death Data application was automated to query vital record deaths, and in 2005 a real-time ED surveillance pilot, the Automated Hospital ED Data System (AHEDD), was developed by STC to replace manual ED surveillance. Over the past decade NH continued to expand the original concept with innovative approaches to identify undetected or under reported disease outbreaks.

Objective

To illustrate development of syndromic surveillance in NH, share innovation experience with the public health community, and contribute to the syndromic surveillance body of knowledge in the new public health Information Technology landscape.

Shenzhen is a special economic region in southern China, adjacent to Hong Kong, with a population of approximately 14 million. The pioneering efforts of Shenzhen in the development of electronic disease surveillance started as early as in 1995. The setup of syndromic surveillance was started after the SARS outbreak in 2003, including surveillance in Fever Clinics, GI clinics, selected schools, and sentinel surveillance for the workers in selected chicken farms and bird markets. In 2007, a regional plan was developed for systematically integrating the surveillance for environmental health, food safety, lab information systems, infectious disease notification, and outbreak management.

Objective

This paper introduces the challenges and lessons learned from the planning and development of a regional integrated disease surveillance system, presenting a new method to quantitatively measure IT support capabilities in disease surveillance and control, as well as a collaboration model integrating the information from multiple sources.

After the SARS outbreak in 2003, Beijing established Fever Clinics in major hospitals for the early detection of potential respiratory disease outbreaks. The data collection in Fever Clinics contains the basic patient information, body temperature, cough, and breath condition, as well as a primary diagnosis. Since the symptoms and diagnosis are mainly recorded in free text format, it is very difficult to use for data analysis. Because of the problems in data processing, the data collection has decreased.

Objective

This paper describes the methodology in the development of an Integrated Surveillance System for Beijing, China.