Hospital program monitors outbreaks

A new software program at Bloomington Hospital now registers patients by their names, addresses and "chief complaints" or symptoms to prevent the rise of certain health issues.\nThe Public Health \nEmergency Surveillance System collects information on patients' symptoms from the emergency room check-in desk and local pharmacies. Epidemiologists analyze this information in Indianapolis at the Regenstrief Institute, an internationally recognized informatics and healthcare research organization.\n"To identify any type of outbreak, we need a way to know," said Vickie VanDeventer, a Bloomington Hospital infection control practitioner. "What would be nice is for us not to just have to think we're seeing more people with diarrhea, but to have an automated way to tell us, in case we miss it." \nIf the system surveys an increase in either drug sales or filed symptoms, the State Department of Health will deem a hospital in "yellow," "orange" or "red" flag emergency. If the program identifies an increase of specific symptoms for a couple of days, the department will issue a red flag to notify the infection control practitioner at the hospital. The infection control division then conducts an investigation to find the source.\n"It is likely to be helpful," said Javed Mostafa, a professor in the School of Informatics who deals with health monitoring systems. "Any unusual pattern of ER traffic could help trigger closer focus into a potentially emerging health threat and support appropriate officials to address health needs in a timely manner." \nPHESS was originally conceived in response to anthrax threats, VanDeventer said. She was appointed to the state advisory committee in 2002, the Hospital Bioterrorism Preparedness Planning Committee, which developed the program. \nConsequently, Bloomington Hospital was one of the original PHESS pilot hospitals and is currently the only hospital that allows access to PHESS records by Bloomington Hospital \ninfection control practitioners.\n"Right now there are actually 42 hospitals throughout the state that are in (PHESS) and over time, all hospitals will be connected," VanDeventer said. "But we have to start somewhere, work out the bugs and get the system in place."\nAn example of a bug occurred in September, when VanDeventer was notified that Bloomington was seeing an increase in respiratory illnesses.\n"I went to the emergency department, talked to physicians and nurses, trying to identify some type of outbreak," VanDeventer said. "It was just an \nincrease in allergies (because of) students just coming back to Bloomington."\nJohns Hopkins University designed the software, which has been modified to fit Bloomington's needs, but bugs still remain. \n"It is important to design the data entry and update interfaces in a manner that introduces minimal overhead in the process and also helps to eliminate errors," Mostafa said. \nThrough classes like Intro to Human Computer Action and User Design Interfaces, Mostafa and his IU students are working with many of the same issues that the surveillance system does. \nOne success of the system came when the program identified an increase in gastrointestinal symptoms, diarrhea and abdominal pain. The patients reporting the symptoms were predominantly senior citizens. \nThe increase was tracked to one of Bloomington's senior housing facilities. The owners were notified and shortly after, gastrointestinal stats returned to their normal levels.\n"It's really an exciting advancement in identification and communication," VanDeventer said. "No one is here 24-7 to figure these things out, so this has been a great help"