Study Examines the Status of State and Local Government Disease Surveillance Systems

Recent outbreaks of diseases like SARS, avian influenza and monkey pox -- as well as the predictions of the potential for massive disease outbreaks following the tsunami in southeast Asia -- are serving as wake-up calls for governments around the world, and in particular, U.S. state and local government leaders. Should a disease outbreak occur locally, how well would a state or local jurisdiction and its affiliated health organizations be able to respond? The Center for Digital Government recently examined this issue from a technology perspective in a white paper called "Tracking Silent Killers: Are State and Local Governments Effectively Implementing Disease Surveillance Systems?"

The Center surveyed 46 states and several large localities to determine to what degree they are effectively utilizing IT in public health preparedness efforts.

The study found that 57 percent of the jurisdictions surveyed either had a disease tracking and surveillance system in place or had begun implementing one.

"That number is encouraging, but we hoped to see it higher," said Mark Struckman, vice president of research at the Center for Digital Government. "States that utilize technology will be better equipped to react and respond to an outbreak, whether it's a disease or a bioterrorism event."

According to the white paper, a common problem with disease reporting and surveillance is the delay experienced from incident awareness, through laboratory testing and ultimately to public health investigation.

"Effective outbreak and epidemic prevention or containment is about collapsing that cycle time," Struckman added. "And technology can do that."

The Center's assessment of technology's role in disease tracking and surveillance concurs with a May 2003 report by the U.S. General Accounting Office. The report, "Information Technology Strategy Could Strengthen Federal Agencies' Abilities to Respond to Public Health Emergencies," claims technology can be more effective when state and local systems work together.

"IT can more effectively facilitate emergency response if standards are developed and implemented that allow systems to be interoperable," the report said.

A case study outlined in the Center's white paper supports the claim that technology can be a vital tool in saving time and lives during a disease outbreak, especially when states use an interoperable system, since diseases "know no borders." The study examines how Pennsylvania, with the assistance of private firm Deloitte Consulting LLP, created the Pennsylvania-National Electronic Disease Surveillance System (PA-NEDSS). PA-NEDSS electronically routes reportable disease data from health care providers directly to public health investigators throughout the state, who can then quickly launch investigations into how a disease may have been contracted, what prevention methodology should be followed, who infected individuals came into contact with, and other critical information. And, because Pennsylvania is offering PA-NEDSS to other states at no cost, more states now have the opportunity to adopt a similar, interoperable system that can strengthen overall U.S. disease outbreak response. KW