Biology Reference
In-Depth Information
16.3 The North Carolina Disease Event Tracking
and Epidemiological Collection Tool
The monitoring of the 2007 heat wave by the North Carolina Division of
Public Health and the response it enabled represents an archetypical
example of using syndromic surveillance to enhance situation awareness
of an emerging crisis. The North Carolina Disease Event Tracking and
Epidemiological Collection Tool (NC DETECT) is among the nation's lead-
ing syndromic surveillance information systems. According to Dr. Jean-
Marie Maillard, Director of the Communicable Disease Branch in the North
Carolina Division of Public Health, prior to NC DETECT, public health data in
North Carolina had not changed much since the Centers for Disease Control
and Prevention (CDC) installed Epi Info
™
in the health department offices in
1987. Before NC DETECT, North Carolina's Division of Public Health relied
on traditional surveillance methodologies, such as physician and lab reports
of nationally notifiable diseases as mandated by state law, sentinel influenza
reporting, and national annual surveys for chronic conditions such as diabe-
tes. These data were often incomplete and weeks to months old by the time
they reached the health department and failed to track the vast majority of
health conditions and injuries. State health officials had long wanted a bet-
ter surveillance system for North Carolina, but the funds to support such a
system were out of reach.
Following the terrorist attacks of 2001, Washington, DC, grew increas-
ingly interested in surveillance and funded the development of systems
that could provide early warning and detection of future attacks. Dr. Leah
Devlin, then the state health director, and others at the division viewed the
new source of funding as an opportunity to develop the type of compre-
hensive monitoring and surveillance system they had long thought North
Carolina needed. Health officials decided to use the newly available surveil-
lance monies to vastly expand a small pilot project run by the University
of North Carolina at Chapel Hill. Led by Dr. Anna Waller, that project was
attempting to get hospital admission data reported back to the University
on a daily basis, and Waller was interested in the greater reach and fund-
ing her project could obtain through collaboration with the state. Together,
State Health Department officials, the North Carolina Hospital Association,
Waller, and her team of researchers envisioned a system that would take
chief complaint information and other admission notes entered into a com-
puterized ED record system from EDs across the state and route that infor-
mation to the health department on a daily basis. Real-time reports of these
data could then be generated twice daily for the health department to use to
track health impacts regionally and among specific population groups.
