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  • by ziggy (25) on 2006.02.13 17:30 (#46141) Journal
    First, he was discussing the many benefits of HIT infrastructure interoperability and he brought up "bio-surveillance." I understand the desire for it, but it scares the hell out of me.

    What, specifically, is so scary?

    As I understand it, in the state of Massachusetts, public health monitoring is using Victorian-era monitoring techniques. Each county's public health office periodically gathers up reports of "interesting" cases, which are accumulated weekly and sent back to the State public health office. These are gathered together into state-wide summaries that take perhaps a week to prepare. Lots of paper is shuffled in the process. Automation is mostly limited to fax machines and (possibly) email for periodic reporting.

    It's all very slow, lethargic, and bureaucratic. The net result is that if there's an outbreak of something, like viral meningitis or epidemic flu, it takes weeks to notice the patterns and alert practitioners. What makes it all the worse is that the local public health offices need to wait for a full state-wide reporting cycle to hear what's happening 2 miles down the road in another county. And that's not counting any of the reporting that falls between the cracks for whatever reason.

    Sad thing is, that's par for the course at both the statewide and national level. About the only thing that does work is when a huge spike of something odd like legionella, e. coli or SARS crops up in a localized area within a single jurisdiction.

    • I didn't explain: it's not surveillance like the CDC would do, it's surveillance like the Department of Homeland Security would do. (I didn't get the exact wording of his statement, sorry.)

      On a separate note: I can't believe how much money being poured into electronic health records. Well, I can believe it (there are no shortages of boondoggles in the world) but I'd be very, very surprised if we hit Bush's milestone of nationwide records by 2014.

      • I didn't explain: it's not surveillance like the CDC would do, it's surveillance like the Department of Homeland Security would do.

        Sorry, but I still don't understand what's so scary. CDC needs to be on top of the public health response if, say, there was a smallpox outbreak. But DHS also needs to be hyper-aware about many of the same situations. Doubly so when you start to hear about some of the plans afoot to mobilize the Army/Nat'l Guard to quarantine a locality (like, say, Haskell County, KS [])

        • Yeah, you're probably right. I think I had my tinfoil anti-Big Brother hat on at the time.

          And I don't think the 10 year timespan is super secret :-) Every president wants to issue an edict as inspirational as JFK's "10 years to the moon", the problem is that they generally don't follow it up with money so it's just another hollow speech.