RODS Laboratory, Center for Biomedical Informatics, University of Pittsburgh, Pittsburgh, Pennsylvania
Bureau of Health Surveillance, Department of Prevention, Ohio Department of Health, Columbus, Ohio
Australian Biosecurity Cooperative Research Centre for Emerging Infectious Disease, Brisbane, Australia
Chapters 2 and 3 described biosurveillance as the world has practiced it for the latter half of the 20th century. During that time, the basic methods for detecting cases, detecting outbreaks, and characterizing outbreaks changed little. The methods used to detect and characterize the 1975 Lyme disease outbreak and the 2003 severe acute respiratory syndrome (SARS) pandemic differed primarily in microbiological techniques (e.g., the increasing use of genetic analysis) and the speed at which outbreaks were investigated.
Around the beginning of the 21st century, however, researchers began to investigate new types of surveillance data and to automate methods for the collection and analysis of these data. A new requirement motivated these researchers—that of very early detection of disease outbreaks (Wagner et al., 2001a). The new methods were met with skepticism (Broome et al., 2002; Buehler et al., 2003; Reingold, 2003; Stoto et al., 2004). Their rate of adoption was slow until the fall of 2001, when the anthrax mail attacks in the United States effectively ushered in a new era of biosurveillance (Wagner, 2002).
We discuss these newer methods in detail in Parts III through V of this book. In this chapter, we discuss the redesign of biosurveillance systems from the perspective of an engineer or a system analyst. To satisfy the new requirement for very early detection, a designer must pay more attention to the systematic aspect of biosurveillance. The designer must examine how quickly outbreaks must be detected and characterized and design a system that can meet these requirements by collecting data that are available earlier than are case reports, collecting those data in real time from existing computer systems in hospitals and other organizations, and analyzing the data in real time.
2. FUNCTIONAL REQUIREMENTS AND
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