BioSense tracking of influenza-like symptoms reported as a percentage of emergency department visits, from April 2009 through Oct. 2011. Now that a Kansas-based network is connected to BioSense, surveillance of potential outbreaks in the state will be increasingly more widespread. by KHI News Service

Kansas has become the first state in the country to connect to the national disease outbreak surveillance system via a digital health information exchange.

Officials at BioSense — the syndromic surveillance system at the Centers for Disease Control and Prevention (CDC) — said that the Kansas Health Information Network on Friday became the first HIE to begin contributing data. Various individual hospitals nationwide already are linked to the system.

Previously just one Kansas hospital — St. Luke’s South in Kansas City, Kan. — was connected to the CDC system, which keeps constant tabs on 89 syndrome categories as mandated by the Public Health Security and Bioterrorism Preparedness Response Act of 2002.

More hospitals contributing

With KHIN joining the system, 10 more Kansas hospitals are now submitting surveillance data to BioSense. And as more Kansas hospitals connect to KHIN, outbreak surveillance in the state will expand, a state health official said.

Kansas state epidemiologist Charlie Hunt said that his office at the Kansas Department of Health and Environment connected to BioSense this spring, but — with just one hospital contributing data — its usefulness for detecting an outbreak in Kansas was limited.

"The highway was built but there was only one car on it. Now there are a lot more cars traveling the highway and we'll be able to utilize the information better. As more facilities begin submitting data to BioSense through KHIN obviously the scope, the breadth and depth of information will be better for us," Hunt said. "This has a lot of potential for us to get information that we have not really had access to before, or information that we've collected in a manual process."

For example, during the H1N1 flu outbreak starting in 2009, KDHE asked hospitals to manually report influenza symptoms observed using a system made for reporting bed availability.

"That was a very labor-intensive process for them to go through their electronic health record system, manually pull out the number of patients (with flu-like symptoms) and then enter it into a separate system," Hunt said. "Once we get high enough participation in BioSense, we'll be able to query the system for influenza-like symptoms rather than have to have the hospitals report to us separately."

Reporting categories

Among the 89 reporting categories are a wide variety of symptoms that — when aggregated across larger geographic areas — can reveal any number of possible outbreaks tied to a common diagnosis, including: asthma, abdominal pain, nausea and vomiting, hemorrhages, rashes and even spates of vehicle crashes.

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