Effective public health response to emerging infectious diseases, natural disasters, and bioterrorism requires access to real-time, accurate information on disease patterns and healthcare utilization. The ESSENCE surveillance system in use by the Department of Defense (DoD) relies primarily on outpatient clinical impression diagnosis, which accurately characterize broad disease syndromes but may not be sufficient for monitoring specific diseases. DoD outpatient military treatment facilities perform nearly 500,000 microbiology laboratory tests annually. Initiated electronically, the ordered test is recorded immediately; most provide specific results in 24 to 72 hours and may prove useful for monitoring population health. Although a syndrome classification has been developed for laboratory tests, the classification cannot be applied directly to the DoD data and no previous study has validated the use of automated laboratory test orders for syndromic surveillance.
Objective
To evaluate the association between military microbiology laboratory test orders and infectious disease patterns.