Biology Reference
In-Depth Information
Creating specific new filters would be more difficult if it were not for
the inclusion of the “triage note” in the NC DETECT database. The triage
note greatly increases the amount of information available to NC DETECT.
For example, the chief complaint could be “diarrhea and vomiting,” which
classifies the case as gastrointestinal syndrome. If the triage note indicates
“patient reports eating peanut butter of the same brand that was recalled,”
then the case would be added to the syndrome for that particular outbreak.
The triage note improves the quality of the data users see, and improves
their efficiency during investigations.
11.3.3.4 Case Detection
NC DETECT also enhances traditional systems of surveillance because cases
of disease that may otherwise go unreported can be detected using the sys-
tem. The user described earlier who follows up every case of meningoen-
cephalitis in NC DETECT also noted that if the case is ultimately diagnosed
as meningococcal meningitis, she reports it to DPH, knowing that it may not
be reported through any other means. Alternatively, DPH can follow up on
a single case detected in NC DETECT either directly through the medical
record, or by placing a call to the local health department or hospital. A key
advantage of a distributed system that allows multiple users to see the data
is it reduces the potential for an important case or cluster to be missed. If a
hospital user, for example, misses a case or cluster, then it could be identified
by another user at the local health department or the DPH.
Triage notes are an important feature of the system's case detection capabili-
ties. One outbreak of foodborne disease among young adults occurred during
the winter holiday break. Using the triage notes area, epidemiologists were able
to identify a cluster of cases in students from a university not in session at the
time. The outbreak was investigated, and the likely cause was determined to be
a food item at a sorority social function held just before the students left the uni-
versity for their vacation. It is unlikely this outbreak would have been detected
with a traditional surveillance system because the cases became geographically
dispersed once they left campus and thus more difficult to identify.
11.3.3.5 Communication
Several users reported that NC DETECT has greatly improved communi-
cation within and among hospitals and public health authorities. Reports
produced by NC DETECT data are prepared and sent to the local health
departments, regional public health teams, DPH, hospital administrators,
clinicians, and even to the community. The ability to view disease trends
across the state has also helped hospital-based epidemiologists and infection
control practitioners feel more informed and linked to other hospitals. One
user also indicated that because of NC DETECT
“
we talk a lot more on how
to deal with illness than we did before.”
