Public Health Surveillance: The Role of Clinical Information Systems

Abstract

Summary: Recently, health departments have begun collecting data from hospitals in near real time for public health surveillance. In New York City, Boston, and Washington, for example, hospitals send daily reports of visits to the health department.This new trend is driven by the need for early warning of surreptitious biological attacks. The trend is likely to accelerate because evidence is accumulating that these new approaches work-that they can detect outbreaks earlier than existing methods and even identify outbreaks that have heretofore gone unnoticed.This trend has important implications for researchers and developers in clinical informatics: It is creating new design requirements for clinical information systems.This chapter is written for both the public health reader as well as clinical informatics reader. For clinical informaticians, it provides a primer on public health surveillance, drawing on examples from our experience with the RODS system, which is a regional public health surveillance system. For public health workers, it provides a primer on clinical information systems, also drawing on examples from our experience with the Health System Resident Component (HSRC), a hospital-based component similar to a clinical event monitor.