Chicago Health Event Surveillance System (CHESS)
Motivated by the need to meet Public Health Informatics Network (PHIN) preparedness requirements and implement NEDSS, the Chicago Department of Public Health (CDPH)embarked on a process to transform disease surveillance in Chicago.| CDPH planned to develop a truly integrated electronic disease surveillance system, using an open-ended requirements-gathering effort involving CDPH disease control programs, hospital infection control practitioners, and the Illinois Department of Public Health. Requirements gathering and system development were more labor intensive than purchasing an off-the-shelf solution, but CDPH believed that building a system on broad program consensus and the local business needs of a high-volume urban local health jurisdiction would serve the department’s needs well into the future. |
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The resulting Chicago Health Event Surveillance System (CHESS) – launched in the spring of 2007 – began receiving reportable disease data from two major Chicago hospitals immediately. CHESS is currently used by CDPH’s Communicable and Vaccine Preventable Disease, Tuberculosis, and Sexually Transmitted Disease programs, and is integrating functionality for the HIV/AIDS, Lead Poisoning Prevention, and Vital Records programs. |
Designed for Usability
CDPH recognized the importance of hospital infection control practitioners as “disease control partners,” and designed CHESS to be useful to these disease reporters by integrating work flow functions that are modifiable based on each facility’s specific business practice.
In addition, in determining CHESS content, CDPH programs sought to limit the type of condition-specific questions asked of reporters in CHESS to those that help establish whether an illness meets a case definition, and to assess the priority of the illness. CHESS only asks reporters to answer specific questions for which the medical record would be the most authoritative source. Data that is more likely from a patient interview can be added in a searchable free text field, allowing for easier hypothesis generation.
The Future of CHESS
CDPH leadership plans for CHESS to become the platform for integrating public health preparedness functions, including early event detection, large outbreak management, and countermeasure response administration. An important consideration toward this end is building these functions into the same system that most program personnel use on a daily basis, increasing the prospects for effective staff cross-deployment during large-scale emergencies.
CHESS is now being rolled out to hospitals throughout Chicago, and the development team is currently working on interfaces to send HL-7 messages to I-NEDSS, the Illinois disease reporting system, as well as receive ELR reports automatically generated by the diagnosis of a reportable condition in the electronic medical record system currently being implemented across CDPH clinics.
Once fully deployed, CHESS will be the core of the disease surveillance and public health preparedness infrastructure for Chicago.