Biology Reference
In-Depth Information
those represented in the SPN data. DPH uses NC DETECT data and SPN
data to validate each other, and for the past two influenza seasons have
found that the two surveillance systems correlate well in terms of timing
and relative size of peaks (http://www.epi.state.nc.us/epi/gcdc/flu2006
.html).
In the event of a pandemic, users predict the value of NC DETECT will be
“huge,” although opinions varied about what aspects of the pandemic would
benefit most from NC DETECT. One user thought it would be most useful in
informing decisions regarding where antivirals and response would be most
needed, while others thought it would be most useful for early detection,
particularly if pandemic influenza struck outside of the normal influenza
season, when SPN was not active.
One user predicted that NC DETECT would be very useful during a pan-
demic because it would require no additional effort for the hospitals to enter
data, whereas the SPN might break down if physicians were swamped with
ill patients (or they themselves became ill). On the other hand, as another
user noted, in a pandemic hospitals would be similarly overwhelmed and
routine data entry might drop off or cease altogether. Also, patients may be
presenting to off-site emergency wards with limited capabilities for report-
ing. Several users pointed out that during the peak of a true pandemic, pro-
viding care to ill persons would be paramount, and collecting and analyzing
surveillance data could come later.
11.3.5 What Have been the Challenges to
implementing biosurveillance?
Key informants had several thoughts about barriers to the implemen-
tation of the system. One stakeholder who has been involved with NC
DETECT since it was a pilot project in 1999 summed up the barriers as he
perceived them:
Policy is the number one [barrier]. Technology was the relatively easy
part. We had to overcome policy concerns and liability concerns. And I
would say the lesson learned there was to create safe harbors whenever
possible for easing the concerns of providers in providing information.
Number two impediment is priorities. The number of initiatives and
projects before hospitals is enormous. So getting a high priority on this
is an issue.
Other informants echoed these sentiments and emphasized the complex-
ity and enormity of the task of building a statewide system, as well as secur-
ing the buy-in of key stakeholders:
… It takes a lot of determination, commitment both from within the
higher up in the agency … it is extremely complex in that way. When we
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