Health network to identify diseases, bioterrorism

Several people are admitted to a local hospital with similar symptoms, and health professionals want to check for clues in their town. A handful of people show signs of suffering from E. coli bacteria, and doctors want to track the outbreak and alert food officials. And as diabetes trends change, health professionals need to watch the shifts and coordinate prevention strategies.

Each of these scenarios requires health professionals to share data instantly, calling for a system to standardize and consolidate the data. Enter the Centers for Disease Control and Prevention's Public Health Information Network.

The network, which would receive a $10 million boost in the proposed fiscal 2004 budget, would build on existing CDC systems, such as the Health Alert Network and the National Electronic Disease Surveillance System, to establish an exchange of data among public heath professionals.

"The ultimate endpoint of all this is the moment the clinician diagnoses a case, it automatically sends a message to the local health department, state health department and the CDC," said James Seligman, CDC's chief information officer. "It's about timeliness and it's about quality."

John Loonsk, CDC's associate director for informatics, said clinical care systems are not standardized. Hospitals enter information differently, and public health organizations have not historically dedicated resources to information technology infrastructure. Furthermore, health care institutions need a reason to network.

"What are the incentives to get provider networks to share information?" Loonsk asked. "They don't do that well."

Consolidating the systems used to report illnesses and cutting down on paper-based reporting would increase the volume and accuracy of statistics from reports. Rather than ask health care professionals to re-enter patient information into a common database, CDC officials want to build on current data. This would require CDC officials to motivate software companies to add the Public Health Information Network's capabilities to current systems.

Eventually, CDC and public health professionals will be able to instantaneously track natural disease outbreaks and bioterrorism events and improve response and prevention.

Pat Libbey, executive director of the National Association of County and City Health Officials, said he supports the system, but thinks the task of making it actually work is daunting.

"It is seemingly simple. The objective is clear," he said. "The implementations to make it relatively seamless are complex. It's going to be hard."