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Health Information Data Sharing: Use of Disease Outbreak Detection Systems across Jurisdictions

posted on Tue, Sep 30 2014 3:31 pm by Mid-States Region

Syndromic surveillance is a term applied to a loose category of practices intended to “identify illness clusters early, before diagnoses are confirmed and reported to public health agencies, and to mobilize a rapid response, thereby reducing morbidity and mortality,” according to the article, Overview of Syndromic Surveillance. Syndromic surveillance has also been referred to as an “early warning system” or “outbreak detection system”. These programs typically gather symptomatic information that may indicate a disease outbreak. In addition, some reporting systems are designed to gather alternative, non-symptomatic data. Some years ago, for example, many jurisdictions began tracking avian deaths as part of their West Nile Virus surveillance effort.

The Network was recently contacted by a requestor who asked for a general overview of statutory authority for the use of syndromic surveillance across jurisdictions.

Some states, such as North Carolina, have passed laws requiring that their state health department establish a syndromic surveillance system and specify by rule the data elements that hospital emergency departments must report to the system. North Carolina’s law also expressly prohibits the collection of personal identifiers and makes syndromic surveillance confidential, although de-identified data may be provided to the Centers for Disease Control and Prevention (CDC). Two other states that expressly allow the development of a syndromic surveillance system are Illinois and Nebraska.

In states without an express mandate establishing syndromic surveillance systems, health departments may be able to conduct such surveillance pursuant to their general public health powers or public health surveillance authority. For example, while Michigan is without a specific syndromic surveillance statute, the Michigan Department of Community Health encourages voluntary hospital participation in syndromic surveillance. Michigan describes its surveillance system, and provides reasons hospitals should participate, on its website.

The New York City Department of Health and Mental Hygiene also conducts syndromic surveillance. An examination of New York City and State general authorities related to syndromic surveillance can be found here.

Finally, BioSense 2.0, a CDC-led effort with the Council of State and Territorial Epidemiologists, the Association of State and Territorial Health Officials, and the National Association of County and City Health Officials, seeks to create a nationwide syndromic surveillance system. Through BioSense 2.0 individual states can upload their syndromic surveillance data to a developed platform and can allow the CDC and other states to access aggregate information to the extent authorized by each participating state.

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