New syndromes could be developed or existing ones modified to cover the
specifics of a public health outbreak or incident.
11.1.3 NC DeTeCT Data Collection, Processing, and analysis
All data collected in NC DETECT are secondary data. They are collected
in electronic data systems for other purposes and NC DETECT receives an
extract of what is already being captured. The NCHA, through NCHESS,
establishes the data feed from each participating hospital to a third-party
data aggregator. The data aggregator then makes a file of the collected ED
visit data available for download to NC DETECT twice a day. The UNC DEM
performs extraction, translation, and loading of the data into the emergency
department database in NC DETECT, monitors and addresses data quality
issues, bins the visits into the various syndrome categories, analyzes the data
using CDC algorithms from the Early Aberration Reporting System (EARS),
and presents the data through a sophisticated Web portal to a variety of users
around the state. The EARS algorithms are programmed to detect unusual
clusters of illness based on syndrome, date, facility, and county of residence.
If an unusual cluster is identified, it is highlighted with a “signal” to alert the
appropriate NC DETECT users when they log in to the system.
The statewide CPC receives more than 120,000 calls each year, and data
are sent to NC DETECT every hour. Calls include human exposures, animal
exposures, and informational calls. Of the human exposure calls, 99% are
assigned at least one clinical effect. Categories of the clinical effects include
cardio, dermal, fever, gastro, hemorrhagic/hepatic, neuro, ocular, renal, and
The UNC DEM produces reports of the analyses, which are available to
authorized NC DETECT users via the Web portal. Users view alerts, the
information for each “case” in an alert, and can investigate and notate alerts
further. Epidemiologist users are also able to post comments for individual
alerts, including results of further investigation, communications with col-
leagues, and determinations that no additional follow-up is required. The
NC DETECT application also allows users to conduct their own queries and
analyses unrelated to any specific alert.
11.1.4 NC DeTeCT users
Users of NC DETECT data include hospital-based epidemiologists, local
health departments, regional public health preparedness teams, and DPH
as presented in Table 11.2. Users who perform investigations as part of their
job functions generally have broader data access for their respective jurisdic-
tions than other user roles. DPH users and hospital users are also able to
access additional systems outside of NC DETECT to review medical charts
of patients seen at select hospitals remotely.