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Case Reporting

Mandatory notification to public health of priority communicable diseases (CDs) is a cornerstone of disease prevention and control programs. Increasingly, the addresses of CD cases are used for spatial monitoring and cluster detection and public health may direct interventions based on the results of routine spatial surveillance. There has been little assessment of the quality of addresses in surveillance data and the impact of address errors on public health practice.

We launched a pilot study at the Montreal Public Health Department, wherein our objective was to determine the prevalence of address errors in the CD surveillance data. We identified address errors in 25% of all reported cases of communicable diseases from 1995 to 2008. We also demonstrated that address errors could bias routine public health analyses by inappropriately flagging regions as having a high or low disease incidence, with the potential of triggering misguided outbreak investigations or interventions. The final step in our analysis was to determine the impact of address errors on the spatial associations of campylobacter cases in a simulated point source outbreak.

 

Objective

To examine, via a simulation study, the potential impact of residential address errors on the identification of a point source outbreak of campylobacter.

Referenced File
Submitted by hparton on

Traditionally, public health agencies (PHAs) wait for hospital, laboratory or clinic staff to initiate case reports. However, this passive approach is burdensome for reporters and produces incomplete and delayed reports, which can hinder assessment of disease in the community and potentially delay recognition of patterns and outbreaks. Modern surveillance practice is shifting toward greater use of electronically transmitted disease information. The adoption of electronic health record (EHR) systems and health information exchange (HIE) among clinical organizations and systems, driven by policies such as the meaningful use™ program, is creating an information infrastructure that public health organizations can take advantage of to improve surveillance practice.

Objective: To enhance the process by which outpatient providers report surveillance case information to public health authorities following a laboratory-confirmed diagnosis of a reportable disease.

Submitted by elamb on

Real-Time Biosurveillance Program (RTBP) introduces modern surveillance technology to health departments in Sri Lanka and Tamil Nadu, India. Triage data from each patient visit (basic demographics, signs, symptoms, preliminary diagnoses) is recorded on paper at health facilities. Case records are transmitted daily to a central database using the RTBP mobile phone application. It is done by medical professionals in India, but in Sri Lanka, due to staffing constraints, the same duty is performed by lower cost personnel with limited domain knowledge. That results in noticeable differences in data entry error rates between the two locations. Most of such issues are due to systematic and subjectivemisinterpretations of the handwritten doctor notes by the data entry personnel. If not identified and remedied quickly, these errors can adversely affect accuracy and timeliness of health events detection. There is a need to support system managers in their efforts to maintain high reliability of data used for public health surveillance.

 

Objective

We present a method for automated detection of systematic data entry errors in real time biosurveillance.

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Submitted by hparton on

When a reportable condition is identified, clinicians and laboratories are required to report the case to public health authorities. These case reports help public health officials to make informed decisions and implement appropriate control measures to prevent the spread of disease. Incomplete or delayed case reports can result in new occurrences of disease that could have been prevented. To improve the disease reporting and surveillance processes, the Utah Department of Health is collaborating with Intermountain Healthcare and the University of Utah to electronically transmit case reports from healthcare facilities to public health entities using Health Level Seven v2.5, SNOMED CT, and LOINC. As part of the Utah Center of Excellence in Public Health Informatics, we conducted an observation study in 2009 to identify metrics to evaluate the impact of electronic systems. We collected baseline data in 2009 and in this paper we describe preliminary results from a follow-up study conducted in 2010.

 

Objective

This paper describes a comparison study conducted to identify quality of reportable disease case reports received at Salt Lake Valley health department in 2009 and 2010.

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Submitted by hparton on

The North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) serves public health users across NC at the local, regional and state levels, providing early event detection and situational awareness capabilities. At the state level, our primary users are in the General Communicable Disease Control Branch of the NC Division of Public Health. NC DETECT receives 10 different data feeds daily including emergency department visits, emergency medical service runs, poison center calls, veterinary laboratory test results, and wildlife treatment.

In order to fulfill our users’ needs with NC DETECT’s limited staff, business intelligence tools are utilized for the acquisition and processing of our multiple, disparate data sources as well as reporting our findings to our numerous end users. Business intelligence can be described as a broad category of application programs and technologies for gathering, storing, analyzing, and providing access to data to help enterprise users make better business decisions.

 

Objective

We report here on how NC DETECT uses business intelligence tools to automate both data capture and reporting in order to run a comprehensive surveillance system with limited resources.

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Submitted by elamb on

Infection Control Law in Japan has asked doctors to cooperate in syndromic surveillance for pandemic flu and smallpox since 2007. However, doctors have to report by typing the number of patients on the web site, or by sending a fax to local public health centers. It imposes the heavy burden of reporting, and thus it has not worked well yet. Therefore, we need an automatic system for routine syndromic surveillance.

 

Objective

We performed some syndromic surveillance system for the Hokkaido Toyako G8 summit meeting in July 2008 in Japan as a counter-measure to bioterrorism attack or other health emergency. This presentation shows the workable syndromic surveillance systems in Japan.

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Submitted by elamb on

Professor Hripcsak rightly points out some of the challenges inherent in disseminating and sustaining robust information systems to automate the detection and reporting of notifiable diseases using data from electronic medical records (EMR). New York City'™s experience with automated tuberculosis identification and notification is a salient reminder that sophisticated technology alone is not enough to ensure broad adoption of automated electronic reporting systems. Substantial resources and ongoing active support by a wide range of public health stakeholders are also essential ingredients. We have attempted to engineer the Electronic medical record Support for Public health (ESP) system to make it suitable for widespread adoption but the ultimate success of this endeavour will depend upon sustained collaboration between many parties including commercial EMR vendors, clinical administrators, state health departments, the Centers for Disease Control and Prevention (CDC), the Council of State and Territorial Epidemiologists (CSTE), and others.

Referenced File
Submitted by elamb on

The Electronic medical record Support for Public health (ESP) project by Klompas et al. (1) promises improved public health reporting by exploiting information captured in electronic health records. This project pulls together a number of technologies (health records, terminology maintenance, inference rules, data and transmission standards, security, text processing, and user interfaces) to create a comprehensive reporting system with a public health query feature. The initial deployment at Harvard Vanguard Medical Associates is promising.

Referenced File
Submitted by elamb on

Communicable diseases are underreported by physicians, especially diseases without laboratory tests. The goals of our study were to determine reporting levels for clinical chickenpox, describe clinical data elements common to chickenpox, and assess ability of an electronic syndromic surveillance system, BioSense, to capture chickenpox cases.

Referenced File
Submitted by elamb on

To meet the long-term needs of public health and social development of China, it is in urgency to establish a comprehensive response system and crisis management mechanism for public health emergencies. Syndromic surveillance system has great advantages in promoting early detection of epidemics and reducing the burden of disease outbreak confirmation. The effective method to set up the syndromic surveillance system is to modify existing case report system, improve the organizational structures and integrate new function with the traditional system.

 

Objective

To understand the structure and capacity of current infection disease surveillance system, and to provide baseline information for developing syndromic surveillance system in rural China.

Submitted by hparton on
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