Biology Reference
In-Depth Information
11.1.1 The establishment of NC DeTeCT
In 1999, the North Carolina Healthcare Information and Communications
Alliance, Inc. (NCHICA), convened a group of emergency medicine clinicians
and researchers, hospital administrators, and health informatics profession-
als to discuss how the use of routinely collected emergency department (ED)
data could be captured and used to better understand and research the clini-
cal aspects of emergency medicine. Not long after the group began meeting,
the Centers for Disease Control and Prevention (CDC) became involved and
added public health interests to the group.
One of the first tasks facing the group was to gather data from various EDs
in a structured and systematic manner into a single database. An initial grant
from CDC enabled the University of North Carolina-Chapel Hill (UNC-CH)
to create a database, and pilot the concept that electronic data from dispa-
rate EDs could be collected and analyzed on a routine basis to inform public
health. This CDC-funded project came to be known as the North Carolina
Emergency Department Database (NCEDD) and included three hospitals.
After the events of September 11, 2001, and the anthrax cases that fol-
lowed, the North Carolina Department of Health and Human Services,
Division of Public Health (DPH) used a portion of its federally allocated
funds from the CDC
Public Health Preparedness and Response for Bioterrorism
Program
to continue the work of the NCEDD. The number of participating
hospitals grew from 3 to 24, and data were collected daily from each ED.
Although the sharing of patient data with public health entities was allowed
under the Health Insurance Portability and Accountability Act, some hos-
pital administrators were uneasy about possible liabilities. DPH therefore
worked with the North Carolina Hospital Association (NCHA) to introduce
legislation requiring hospitals in North Carolina to provide timely ED visit
data for public health surveillance. In 2004, the North Carolina legislature
authorized the establishment of the North Carolina Hospital Emergency
Surveillance System (NCHESS) and directed the state's 24-hour acute care
hospital-affiliated EDs (at that time, 112) to provide data to NCEDD for pub-
lic health surveillance purposes, effective January 1, 2005.
In 2004, NCEDD became known as the North Carolina Disease Event
Tracking and Epidemiologic Collection Tool (NC DETECT). Currently, NCHA
supervises data collection from EDs. The DPH contracts with the UNC-CH
Department of Emergency Medicine (DEM) to oversee the NC DETECT sur-
veillance system and to manage the storage and analysis of the ED data. As
of January 1, 2009, 98% (at that time, 110) of the 112 EDs covered by the man-
date provide data at least daily to NC DETECT. The remaining EDs are in the
process of joining the system (www.ncdetect.org).
Additionally, NC DETECT receives data from the Carolinas Poison Center
(CPC) poison control hotline, which covers the entire state of North Carolina;
