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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 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 providers data systems
are being reported to public health. |
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