Standards are crucial for reporting system

Although the Centers for Disease Control and Prevention's push for a nationwide Health Alert Network (HAN) aims to put in place a bread-and-butter alert system for emergency response, the federal agency also is honing analytical tools for use by state and local health organizations. Data standards will play a key role in the new system's development.

CDC's National Electronic Disease Surveillance System (NEDSS) will stitch together health surveillance activities around the country. CDC's goal is to hand agencies an application that will facilitate quicker, more accurate disease reporting and provide integrated databases of demographic disease data for analysis and comparison.

Working with the project's contractor, Computer Sciences Corp., CDC is now completing the first version of NEDSS, a Web-based application built on Sun Microsystems Inc.'s Java 2 Enterprise Edition. Currently, states such as Tennessee and Nebraska are serving as beta sites for the application.

To ensure that local public health organizations will be able to use the tool, CDC has issued a detailed set of standards that must be adhered to if local agencies are to receive NEDSS funding.

"What we are trying to do is insist on systems that are interoperable and built on standards," said John Loonsk, director of CDC's Information Resources Management Office. For instance, NEDSS incorporates standards spawned by the Health Insurance Portability and Accountability Act and ANSI standard HL7, which governs clinical and administrative data.

NEDSS also will include specifications for public health methods based on Extensible Markup Language, the goal being to standardize the reporting of cases of specific diseases among interested parties in the public health system, according to a report on the project by Gartner Inc.

Jurisdictions such as the cities of Milwaukee and New York are attempting to combine their HAN and NEDSS efforts, though that is not necessarily the case everywhere.

Milwaukee, for instance, views its evolving HAN as a portal for NEDSS. "This is attractive for CDC, because it leverages both tools," said Seth Foldy, Milwaukee's health commissioner.

However, since the level of automation at public health agencies varies widely, so too will the pace for NEDSS adoption.

Many local departments "are still working with [older] DOS-based systems, and there is still a lot of paper out there," said David Levitt, CSC's account manager and operations director.