Biology Reference
In-Depth Information
a card is additional work for physicians/laboratories, reporting rates are noto-
riously low. Traditional surveillance for reportable diseases is by definition
passive and generally includes a final diagnosis. The time between when a
patient first presents to the clinician or a specimen is received by a laboratory
and a report is sent to the health department can be lengthy.
NC DETECT, in contrast, which is still a passive system, imposes no extra
burden on the part of the hospitals in terms of reporting, but in the view of
key informants is more timely and complete than traditional surveillance.
As one DPH user explained, “This system is a trigger…. Users still follow
up cases of interest, but they are alerted to the presence of these cases much
earlier than with traditional surveillance, partially because they do not have
to wait for a final diagnosis
.”
To address these potential problems, NC DETECT has a comment area that
can be viewed by all users and where they can note what they have learned
through their investigations. NC DETECT users reported that they make notes
in the comment area and this saves them time. Also, as patients receive diag-
noses within the hospital electronic information system, they are downloaded
to NC DETECT, which then automatically updates the records. The strong
consensus among the users was that NC DETECT was a net gain in terms of
timeliness. Even though the majority of the aberrations they review are not
true outbreaks, they do not view the time spent as excessive or consuming.
In other examples of NC DETECT's enhancement of timeliness, parents,
upon learning about a mercury exposure from their children's school, called
CPC inquiring about the effects of mercury. NC DETECT received data
related to these calls in near real time that could then be monitored by DPH
users. DPH saw the signal and promptly investigated it, and alerted the local
health department.
The North Carolina coast frequently experiences hurricanes, and surveil-
lance for hurricane-related injuries and ED visits is used for emergency
planning and resource allocation. In the past, it has taken approximately 3
months for an epidemiologist to abstract ED charts for a week before and
after a hurricane hits (to compare time periods). With NC DETECT, the same
data can be (and have been) obtained in a matter of hours.
11.3.3.3 Flexibility
NC DETECT is mainly used for ongoing real-time surveillance of particular ill-
ness syndromes. New syndromes or filters can be requested at any time by NC
DETECT users and added to the system by UNC DEM NC DETECT staff, which
greatly enhances the system's flexibility. A new filter can be used to detect new
cases at system EDs, and can also be used to retrospectively find cases. This
feature has been used extensively by DPH users to enhance surveillance of
specific illnesses and syndromes. Some examples have been previously men-
tioned, including the filters for heat-related illnesses and for gastrointestinal
illness related to peanut butter consumption, and a chemical explosion.
