Integrated
Health Information Systems
phone: (404) 639-7860
fax: (404) 639-7770
Centers for Disease Control and Prevention
1600 Clifton Rd.
Atlanta, GA 30333
U.S.A
(404) 639-3311 |
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 Methods
for conducting public health surveillance may often differ considerably
by program and disease. Regardless of these differences, however, all
surveillance activities share many common practices in the way data are
collected, managed, transmitted, analyzed, accessed and disseminated.
The National Electronic Disease Surveillance System (NEDSS) will, primarily
through the creation of standards, facilitate the handling of data through
each of these steps. As described below, different interrelated activities
supporting NEDSS will offer significant improvements in the way public
health surveillance is conducted at the Federal, State, and local level.
The long-term vision for NEDSS is that of complementary electronic information
systems that automatically gather health data from a variety of sources
on a real-time basis; facilitate the monitoring of the health of communities;
assist in the ongoing analysis of trends and detection of emerging public
health problems; and provide information for setting public health policy.
Data
Collection
Cases of a disease or other condition of interest are primarily identified
in the medical care system. Once identified, these cases are typically
reported to a local health department, often using paper-based data collection
forms. At the local health department, forms may be entered into a computerized
electronic data management system and transmitted to the State, or they
may be copied, filed at the local level and then sent directly to the
State where they are manually entered into the State health department’s
electronic system. These reporting processes are generally the same, regardless
of the disease or condition that is being reported.
There are
a number of problems that can arise during the reporting process. These
problems, in turn, often place a large burden on medical care staff who
have responsibility for disease reporting. For example, cases may be reported
from a variety of sources from within the health care setting, such as
clinical laboratories and private physicians. Physicians and laboratory
supervisors and their office staff are already overworked. Nevertheless,
it is often left up to health care providers to determine if a case meets
public health surveillance case definitions and to figure out how to fill
out the wide variety of forms produced by CDC and health departments.
They may also spend significant time tracking down patient records in
response to requests for more information from the health department.
NEDSS will
facilitate the collection of case report forms from providers in two important
ways. First, standards are being developed to assure uniform data collection
practices across the nation. The public health data model and common data
standards will recommend, for example, a minimum set of demographic data
that should be collected as part of the routine surveillance. In addition,
guidelines will provide a consistent method for coding data on the data
collection forms. It is expected that standardizing data collection forms
should ease the burden on physicians and their staff by providing a more
uniform data entry portal for all reportable conditions via secure
web-based systems or, for larger organizations via electronic data
exchange that is automatic and requires minimal burden on healthcare
reporters.
Second,
NEDSS will include recommended standards that can be used for the
automatic electronic
reporting of surveillance data. Specifically, NEDSS will recommend a standard
data architecture and electronic data interchange format to allow computer
systems to generate automatically electronic case reports that can be
sent to local or State health departments. These types of standards would
both ease the burden on large organizations that already have computerized
data systems (such as regional laboratories, hospitals, managed care organizations)
and would ensure that all cases that are in the provider’s data systems
are being reported to public health.
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