Public Release: 

Researchers aim to centralize N.C. emergency room data to combat epidemics, bioterrorism

University of North Carolina at Chapel Hill

CHAPEL HILL -- Hospital emergency rooms constitute a key part of the first line of defense against infectious disease epidemics like SARS and even bioterrorism, but word of what happens in one emergency room might not get out to others for days or weeks. Local, state and national health officials need such information to identify and respond to public health emergencies fast.

Now University of North Carolina at Chapel Hill faculty members are trying to make the system react more quickly to health-care threats. They have linked emergency departments at three institutions -- UNC Hospitals, New Hanover Regional Medical Center and Cape Fear Memorial Hospital -- into the new North Carolina Emergency Department Database (NCEDD).

The Centers for Disease Control and Prevention supported preliminary work to demonstrate the benefits of standardized electronic emergency department data. To expand their fledgling system, the UNC team and colleagues sought and received a new $1.25 million contract from the Office of Public Health Preparedness and Response in the N.C. Department of Health and Human Services' division of public health.

As in the demonstration project, funding was provided to the state by the CDC to expand development of the NCEDD. The funding will enable NCEDD to take in another 10 to 15 of North Carolina's largest hospitals within a year.

Eventually, researchers hope to incorporate all 111 of the state's hospital-based emergency departments, said Dr. Anna E. Waller, research assistant professor of emergency medicine at the UNC School of Medicine. The emerging computerized network could serve as a national model for statewide emergency room data collection and use.

"Because of its potential usefulness, this is something we are pretty excited about," Waller said. "When we get the 20 largest emergency departments in the state to participate, then we'll have details from a high proportion of the overall emergency visits for North Carolina."

The idea, she said, is to collect data that go beyond the typical billing information found in computerized hospital databases.

"We want to include clinical information about patients that is of great interest to health-care providers and administrators and is important for epidemic and bioterrorism surveillance," Waller said. "To be prepared for a serious disease outbreak or bioterrorism-related event, we have to be able to recognize what's happening quickly so we and others can respond."

In the past, North Carolina has not had statewide emergency department data collection since it was not a high priority for state officials, although clinicians and researchers have been interested in the possibility for years, she said.

"Emergency departments are where people go when they get very sick suddenly, and so this will be useful not only for surveillance but also for research and quality-of-care issues," Waller said. "It will provide much information we wouldn't get if we were only looking at local health departments or at patients who were actually admitted to hospitals."

In keeping with state and national laws to protect patients' privacy, their names, addresses and other identifying information such as medical record number will not be collected in the system, she said. An important part of the effort has been to design technical solutions capable of extracting needed data quickly with minimal impact on hospital staff, transmitting it securely and standardizing data from different hospitals. Another key aspect will be learning from similar activities taking place in other states and sharing nationally what the UNC team learns.

"We will have information about when the patient arrived, how they got there, their chief complaint or reason for the visit, the triage nurses' assessments including vital signs, what procedures were performed, diagnoses, were patients admitted to the hospital or discharged and other things," Waller said.

"With this kind of public health surveillance system in place, we will be able to pick up on just about anything from food-borne illnesses and tuberculosis to smallpox and identify many other health threats as well. It will be a marvelous resource."

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By DAVID WILLIAMSON
UNC News Services

Note: Waller can be reached at (919) 843-0389 or awaller@med.unc.edu.

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