Biology Reference
In-Depth Information
11.3.2 How Has biosurveillance been integrated with
Traditional Surveillance activities?
NC DETECT complements traditional surveillance activities, including
reporting. PHEs in the hospitals all reported that they check NC DETECT
signals daily, as a part of their routine surveillance responsibilities. For these
epidemiologists, the focus of their work is on what illnesses are circulating
in the community and presenting at the ED. They use NC DETECT data from
their hospitals, plus potentially other hospitals in the same system, and com-
pare trends and signals with regional and state data. They use additional
sources of data, including medical charts, laboratory data, and medical test-
ing results to investigate signals further. As cases are investigated, users can
add comments into the NC DETECT system that a signal has been investi-
gated, and can report the outcome of the investigation.
Hospital-based users send weekly reports of their surveillance activities
to local health departments, DPH, and hospital administrators. One PHE
said that in addition to the above, she posts her reports on the hospital
intranet, so anyone with hospital privileges can view the reports. She also
sends reports directly to the director of the ED, as well as ED physicians
and pediatricians. Sometimes the local health director (at the local health
department) asks her to send her reports or notices to local physicians who
are not connected to the hospital, so that they are also aware of community
illnesses.
Regional state-based response teams use NC DETECT as part of their sur-
veillance activities for the regions. They may not check the system as often
as PHEs, but review signals daily when warranted by an ongoing disease
outbreak. Because a region may include up to 25 counties, the epidemiolo-
gists review signals by county, and can view a line listing of each signal to
inform them at which hospital the patient presented. Some counties may
require more attention than others, depending on whether the local health
department or a PHE also reviews cases for a county (or a large hospital with
a large patient population from a single county).
State-based epidemiologists monitor the signals from NC DETECT daily.
For approximately half of the hospitals on the NC DETECT system, DPH can
directly access patient medical records to investigate signals. The epidemi-
ologists add comments to signals in NC DETECT as they are investigated,
and review comments other users have entered for signals. They validate
trend data with other sources of disease data for the state, mainly reportable
disease data.
NC DETECT is also used to supplement and complement other forms of
public health surveillance of nonreportable illnesses and conditions. One
hospital-based user described her efforts to facilitate local injury control
activities with NC DETECT. She created special sets of queries to identify
the number and type of injuries presenting to the ED. These data were
