To ensure an effective response to a biological disease outbreak, the outbreak needs to be detected at the earliest possible moment. A variety of initiatives have attempted to develop early warning health surveillance systems, and significant progress has been made. However, each initiative has encountered significant obstacles; to date, not a single major metropolitan area can boast an effective biosurveillance system.
Noblis is developing systems to provide the earliest possible warning of biological outbreaks; these systems are based on the integration of health indicator data and geographical information system (GIS) technology to create a geospatial biosurveillance system. Under the Centers for Disease Control’s (CDC’s) National Electronic Disease Surveillance System (NEDSS) program, state health departments have received grants to develop databases for capturing and tracking public-health indicator data. Through internal Noblis research, and in partnership with other researchers and health care organizations, we have pioneered the concept of bio-surveillance using public health indicators to detect patterns indicative of a biological event. Our conceptual system, under funding from the Defense Threat Reduction Agency (DTRA), is being further developed as we work with the Utah Department of Health to implement a biosurveillance system for the Salt Lake City Olympics. The biosurveillance system exploits indicator data acquired under the NEDSS program to automate health surveillance during the event.
In a separate effort, we are establishing a public–private partnership with Kaiser Permanente to create a biosurveillance system for the national capital area. Kaiser is a nonprofit HMO with a large presence in the Baltimore-Washington area, as well as on the west coast and other locations. Kaiser operates regional call centers that handle urgent and routine medical advice request calls. Incoming calls are currently logged into a database that is integrated with patient medical record data. Using the biosurveillance system, without requiring additional data entry, an authorized user will be able to monitor the volume of incoming calls, filter them according to the nature of the complaint, and analyze them geospatially on the basis of the patient’s home or work address. Indications of a possible outbreak would be reported to governmental health and national security authorities immediately; Kaiser can simultaneously initiate internal actions to further investigate, confirm, and appropriately mitigate the outbreak. The performance of this system is expected to far exceed any other existing or planned biosurveillance system. Privacy concerns will be eliminated since Kaiser will own, operate, and maintain the system for enhancing the health care of its members.