A Neolithic transformation is underway in public health, where the ubiquity of digital healthcare (HC) data is changing public health’s traditional role as data hunter-gatherers to one of data farmers harvesting huge reserves of electronic data. ILINet 1.0 is the current U.S. outpatient ILI surveillance network dependent on ~2000 volunteer sentinel providers recruited by States to report syndromic ILI. ILINet 1.0 began in the 1980s and represents a largely unchanged, ongoing hunter-gatherer approach to ILI outpatient surveillance involving the independent efforts of all state health departments. Many significant changes have occurred in the U.S. healthcare system since ILINet 1.0 was initiated. For example, eCommerce standards emerged in the 1990s creating ubiquitous amounts of easily accessible electronic healthcare administrative data. Since 2001 new public health surveillance approaches and investments have emerged including methods for syndromic surveillance (e.g. BioSense). Most recently healthcare reform efforts hold great promise (as yet largely unrealized) for public health to access electronic information derived from EHRs/HIEs (e.g., Meaningful Use). Could and should the current U.S. gold standard for ILI outpatient surveillance benefit from these new opportunities, and if so, what approach should be used and who should be responsible?
Objective
This paper outlines the current state of ILINet (ILINet 1.0), the accepted national gold standard for outpatient influenza-like illness (ILI) surveillance, and demonstrates how ILINet 2.0 could be more automated, timely, and locally representative if it were to utilize increasingly available electronic healthcare data rather than a specific group of recruited sentinel providers.