Disease Surveillance System Exchanges Public Health Data to Protect U.S. Citizens

System integrates federal, state and local databases to spot disease trends

Recognizing that health surveillance is the cornerstone of public health decision making and practice, organizations at the federal, state and local levels maintain more than 100 information systems for health surveillance. However, these systems were designed separately and in most cases could not share data, so much potential benefit was being lost.

NEDSS: An Integrated Approach to Disease Surveillance

In 1998, the Centers for Disease Control and Prevention (CDC) launched development of the National Electronic Disease Surveillance System (NEDSS) to harness the enormous power of this data and serve as the surveillance component of CDC's Public Health Information Network.

NEDSS is an Internet-based infrastructure for data accumulation and sharing. It provides a standards-based, integrated approach to disease surveillance. Because NEDSS connects public health surveillance systems to clinical information (from medical labs, for example), emerging public health threats and trends can be detected more quickly.

Late in 2000, CDC contracted with CSC to lead development of a NEDSS-compatible Base System (NBS), to be offered to state health departments and eventually to other organizations.

The NEDSS Base System: The Fundamental Building Block

CDC and CSC jointly developed the public health conceptual model, data standards, software and systems infrastructure for NBS. Major technical challenges included supporting the sheer volume of data, integrating multiple disease-specific systems and addressing privacy concerns.

CSC used development tools and methodologies based on the SEI's Capability Maturity Model, Level 3, for software engineering. CSC also collaborated with CDC and others to develop a sharable logical data model for the Base System's Web-based modules, message specifications and data repositories.

NBS enables data entry via the Web and electronic interchange of laboratory data. These features place data entry as close as possible to data sources to reduce errors and speed reporting. NBS’s patient-centric model supports a Virtual File that allows all public health events for a patient to be viewed from one central location. Patient data is connected to an integrated repository of data pertaining to over 140 different diseases and conditions.

Security is built into the system to protect sensitive information, with user security profiles determining access to data.

Standards Make It Work

An important part of the NEDSS initiative is the propagation of standards for public health information systems, including a push to use industry data standards whenever possible.

These standards mean that many systems, not just the Base System (whose use by states is optional) will interface with NEDSS. Standards call for COTS-based systems, Internet-based secure data transmission, common look and feel, common reporting tools, and common data standards. In 2005, recognizing that many state and local governments lacked resources to install and operate a system such as NEDSS. CDC announced that it would offer a hosted version of the NBS to accelerate implementation. CSC won the contract to act as NEDSS’ application service provider and began that work in February 2006.

Results Are Positive

NBS covers 25% of the U.S. population, with over 900 users throughout the country. More than 600,000 Nationally Notifiable Disease (NND) electronic messages have been generated by NBS sites.

NEDSS informs public health officials of emergency room visits for specific diseases and monitors lab results to detect increased frequency of certain conditions. Because electronic data is transmitted automatically, epidemiological investigations are initiated much more quickly. Reporting time for communicable diseases has shrunk from around 24 days to 3 days, with a 300% increase in the number of laboratory reports to public health.

With NEDSS’ improved communications, reliable information and automatic data exchange, public health departments and other stakeholders have timely and accurate insight into the state of the nation’s health, delivering a better, healthier life for all Americans.

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