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Real-time public health surveillance at work in Kentucky

This letter from a reader details public health reporting efforts in northern Kentucky. The system uses rules engines to limit what must be reported. This helps small providers.

Editor's note: SearchHealthIT.com received this feedback in response to the article Data exchange pilot targets public health surveillance in real time. It has been edited for style but not for content.

I recently came across your article about the Alliance of Chicago's project with GE Healthcare and the Centers for Disease Control and Prevention (CDC) regarding real-time public health surveillance.  Emergint Technologies Inc. has been working with the Kentucky Hospital Association, the Kentucky Cabinet for Health and Family Services and hospitals in northern Kentucky communities since 2007. We have been delivering real-time electronic public health surveillance reporting since 2008 in Northern Kentucky, since 2009 in Louisville, and since 2010 in Lexington.

However, I must disagree with the approach that GE Healthcare is taking by sending information to a CDC rules engine before delivering a notification. These "rules" are well-defined and available online for free. It would be more effective for GE Healthcare to (a) embed the rules in its electronic health record (EHR) system or (b) offload the logic to a system dedicated to this analysis. The latter option is what Emergint has developed with its HealthSIS product that is deployed for Kentucky Community Surveillance.

Deploying a small server within the hospital environment and only delivering notifications to public health agencies and local staff for reportable conditions is very manageable and efficient. Our users have demonstrated labor savings of 70% or more in the public health reporting process, and timeliness of the notifications from our system usually matches or is faster than the notification process from the lab. For instance, both local staff and the local public health agency are alerted to a positive salmonella result within seconds of the lab system publishing the result, without any network traffic to CDC.

When you combine these results with the realization within the marketplace that public health agencies have been left out of meaningful use funding, it is easy to see that there are many opportunities for better solutions in this small sector of the health care market. 

Let us know what you think; email Jean DerGurahian, Executive Editor.

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