Libertarian ping.To be added or removed from my ping list freepmail me or post a message here.
Posted on 03/29/2005 4:26:13 AM PST by freepatriot32
In the fight against terrorism, few stones are left unturned.
Every day, patient data from a handful of emergency rooms is sent to the Indiana State Department of Health to be crunched and analyzed.
An epidemiologist watches intently for upward trends in rashes, fevers and unexplained deaths. Or a sudden surge in over-the-counter drug sales.
The practice -- called syndromic surveillance -- broke onto the public health scene immediately after the Sept. 11, 2001, terrorist attacks and later anthrax deaths.
The surveillance method is widely viewed as a tool to detect a possible bioterrorism attack. Computers allow the instant sharing of data, so rapidly spreading diseases can be detected within hours, rather than days.
Indiana's pilot program for syndromic surveillance is currently taking in data from 17 hospitals, most of them in Indianapolis. But 34 hospitals have signed up to participate, including Memorial Hospital and Saint Joseph Regional Medical Center in South Bend.
No terrorism-related investigations have been spawned in Indiana because of the surveillance. But health officials see other benefits, such as using the system to track flu outbreaks or other health threats.
"If an infectious disease like monkey pox broke out, hopefully it will be found through the system immediately, so we can allocate resources and work through public health departments," said Linda Jones, the state's syndromic surveillance epidemiologist.
Safety vs. privacy
Syndromic surveillance -- and the use of sensitive patient information to make it work -- was given a blessing by the Indiana legislature last year.
An anti-terrorism law passed March 9, 2004, permits patient names, addresses and the chief health complaints of patients to be sent to the state Department of Health.
The state is partnering with the Regenstrief Institute Inc. of Indianapolis, a medical research foundation, to help local hospitals install a software system to transmit the data. Forty-five hospitals in the pilot project should be sending data this summer.
The department insists the data won't be misused.
"Confidentiality is maintained throughout, and the privacy of the individual will be maintained throughout," Jones said. "There is strict oversight, and we're using the latest technology."
Some hospitals have objected to the use of patient information, but Jones said state law doesn't leave them much of a choice.
"(The law) gave us a mandate for setting up the system," she said. "We had one hospital that said no. We just took them out of the pilot program.
"But," she added, "they will come online eventually."
'A great tool'
When the state's program is up and running, the surveillance will begin after someone visits the hospital or a pharmacy.
At the hospital, doctors take note of the patient's chief complaints -- such as coughing, fever, body aches, vomiting or diarrhea -- and enter the data into a computer. There is no waiting for a final diagnosis.
Pharmacies also keep track of drug sales in a database.
All the data will be sent to the state, where it will be sorted on the computer by syndromes, such as respiratory, gastrointestinal, hemorrhagic or neurological.
The frequency of illness will be compared against a benchmark for a particular ZIP code. The location and duration of an outbreak will help the state health department decide whether to investigate.
If a problem is suspected, an alert will be generated and the information shared with local health departments.
At Memorial Hospital, computer experts are still setting up the needed data reporting system.
"In the past, I've relied on the alertness of staff, so when they see like symptomology presenting itself, to make a phone call and say, 'Gee, something unusual is happening here. It's the second or third patient we've seen,' " said Susan Kraska, infection control practitioner at Memorial Hospital. "Technology will be catching up with what people were just realizing before."
The hospital's service area is divided into ZIP codes, and a median number is assigned to each one for the number of illnesses normally seen in a given day.
"Say there's a big event at Century Center, and there's a meal served, and all of the sudden, in syndromic surveillance, we see visits to emergency rooms and to local pharmacies, seeking medications for nausea, vomiting and diarrhea," Kraska said. "Once you go above the standard deviation, you are tipped that an event has occurred."
Syndromic surveillance could help doctors and hospitals see the larger picture with disease outbreaks, said Christopher Costello, infection control coordinator at Saint Joseph Regional Medical Center.
Costello said he can add up how many diarrhea cases the hospital has treated in the past month or two. But it takes time to add everything up.
"We don't have a method, currently, to effectively identify outbreaks," Costello said.
"If you can imagine, these diseases that might be reflective of bioterrorism are pretty seasonal. So you wouldn't think much of seeing a diarrheal disease, especially when you have kids out there who might have rotavirus, and the seasonal flu outbreaks.
"That's why syndromic surveillance is key, because we're so close to the seeing-the-forest-through-the-trees phenomenon."
"We think it's a great tool that will enhance our ability to identify a threat earlier, and respond more proactively," said Heather Kuehnle, an epidemiologist and emergency preparedness supervisor for the St. Joseph County Health Department.
'Learning as we go'
Some criticism has also been leveled at syndromic surveillance programs.
The Center for Domestic and International Health Security recently asserted the surveillance systems generate false alarms and may not be effective or necessary in some situations.
The early detection benefit of syndromic surveillance might be unnecessary if there were a simultaneous infection of hundreds of thousands of people, the center concluded.
And cases involving only a few people -- such as the anthrax outbreak in 2001 -- could go undetected, the Santa Monica, Calif., organization found.
Citing its own simulated bioterrorism attack, the center said success of syndromic surveillance can depend on how the data is gathered and evaluated.
The center urged doctors to become more involved in syndromic surveillance so the practice is integrated with the hands-on medical community.
"Many city and state public health agencies have begun investing substantial sums to develop and implement these surveillance systems," the center said. "However, the method is new and still largely untested."
Jones acknowledged the technology is new and there will be some challenges -- especially during the flu season when thousands of people are reporting similar symptoms.
But within two years, Indiana's system will include a variety of sources: coroners' reports, calls to the Indiana Poison Control Center, school absenteeism counts, lab test orders, veterinary lab results, and reports from day-care centers.
"As we develop a historical database," Jones said, "we will know better, over time, what is above the threshold, even above the flu season. We're learning as we go right now."
Staff writer John Dobberstein:
jdobberstein@sbtinfo.com
(574) 235-6187
And if you cant trust a sniveling bueracrat you can you trust?I mean come on its not like private documents have ever been misused by goverment agents for political gain in the past. *Cough fbi documents under the clinton administration cough*.
Libertarian ping.To be added or removed from my ping list freepmail me or post a message here.
Indiana's system will include...school absenteeism counts?
What, are they afraid of JUNIOR TERRORISTS or something?
How wonderful we can protect our schoolkids by having the state government put them into a database and make sure they are well. We could tattoo barcodes on them, too, so we could track them easier. That'd stop terrorism even BETTER.
It's already being attempted.
http://www.freerepublic.com/focus/f-news/1344985/posts
Knowing the baseline absenteeism helps to identify spikes. For example, if school absenteeism in the month of April is usually 6%, or if absenteeism at your major employer is usually 5%, and today you find 13% absenteeism, it's time to start asking questions.
Syndromic surveillance can give a health department a few extra hours, even a day or two, to mount a response that could result in limiting the consequences of an act of bioterrorism.
I think its pure unadulterated crap, but assuming it has any value ... why must individual identities be included in the data?
...In the fight against terrorism, few stones are left unturned....
How about those two ten thousand pound boulders known as our open borders?
Spud, I can't argue against that logic.
In fact, I'm so convinced, I can now say I'm not just a fan of that, I think we should utilize that logic in helping the police put cameras in every home. After all, knowing the baseline of reality in average homes would help to identify spikes. We have a camera in every home and a computer program monitoring them all for what looks like electronics or some other potentially dangerous equipment, and the program catches something that's out of the ordinary, we can send out police to check it out. We could even allow some people to opt out of having the cameras in the bathroom and more private places if they allowed the police to fingerprint them and do a thorough investigation of them. After all, we don't want to get TOO crazy about giving the government details they really don't have to have, and they probably would have a harder time processing too much information.
Anyone arguing about a slippery slope would be silly. The government simply can't do enough to protect the country against terrorists. We should give the government whatever information it needs, no matter how tangentially related to the threat, to prevent terrorism that threatens the liberties we all hold so dear. And anyone who gets in the way of that expansion of government in the name of national security is probably a tinfoil-wearing loony anyway.
/blistering sarcasm
Ping to 8.
Slacker!
If you really want to be safe, we should strip everyone naked, tie them up and place them along the yellow lines of superhighways.
According to liberals the more helpless we are, the safer we are.
Are you crazy man most "accidents" happen in the bathroom.But really how many of those so called "Accidents" are really practice runs for national terrorist activitys? The only way you would be against placing cameras in the bathroom is if you yourself were a commie pinko terrorist and you dont want the cameras catchingt you in the act.I'm removing you from my libertarian ping list and calling the department of homeland security and the fbi. enjoy your lifettime stay in gitmo you islamofascist ba**ard
ahem based on the vitriolic profanity laden email I just recieved I thought it would be prudent to tell you I was just kidding in my last post about sicking the feds on you in case you cant tell when im joking or not when i forget the sarcasm tag like some lurkers to free republic apparently cant.
oh yeah and you are still a member in good standing of the libertarian ping list :-)
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