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Cindy Fox Aisen
IU School of Medicine

Last modified: Thursday, January 17, 2008

Battling Potential Disease Outbreaks Online: Public Health Surveillance In Real Time

Jan. 17, 2008

INDIANAPOLIS -- Public health officials are constantly in battle mode against illness from food contaminants or a possible pandemic, but to fight these deadly foes they need more complete information and they need it faster.

Researchers from the Regenstrief Institute and the Indiana University School of Medicine have found that automated electronic medical laboratory reporting (ELR) improves both the completeness and timeliness of disease surveillance, significantly bettering the odds of stopping the spread of disease. Their study appears in the February issue of the American Journal of Public Health.

Working with the Marion County Department of Health, the physician researchers compared ELR and paper reports from doctors, hospitals and laboratories, the current standard in public health surveillance. ELR findings are automatically transmitted in real time, as results are completed. Paper reports are manually prepared as staff members assigned to the task have time.

"Doctors offices, clinics and public health officials across the United States are currently doing a very good job but if we rely on the traditional, slower paper approach to disease surveillance, there is less opportunity to intervene at an early stage. And, with many of these diseases, time is of the essence," said J. Marc Overhage, M.D., Ph.D., first author of the study.

The researchers believe that the higher rate of completeness they observed with ELR resulted from overcoming a number of barriers, including lack of awareness by the providers of the need to file reports, human error, lack of motivation and ineffective processes.

Building an ELR capability is very feasible, according to Overhage, who with study senior author Clement McDonald, M.D., has led efforts which have made Indianapolis the most wired healthcare environment in the United States. "We are laying a foundation so ELR can happen not just in Indianapolis, but across the country," he said.

Overhage is the director of medical informatics at the Regenstrief Institute and Regenstrief Professor of Medical Informatics at the IU School of Medicine. He also is president and chief executive officer of the Indiana Health Information Exchange, a collaboration of Indiana health care institutions to help improve patient safety and efficiency.

McDonald, director emeritus of the Regenstrief Institute and IU School of Medicine professor emeritus of medicine, currently directs the Lister Hill National Center for Biomedical Communications at the National Library of Medicine. This study was supported by the NLM.

The study also was co-authored by Shaun Grannis, M.D., a Regenstrief research scientist and IU School of Medicine assistant professor of family medicine, who is a biosurveillance expert. He works closely with many public health departments.