State epidemiologists and the Centers for Disease Control and Prevention are on their way to creating a national standard list of health conditions that public health authorities should be notified about.
The working list has 68 diseases such as typhoid, AIDS, E. coli infection and anthrax. Now the epidemiologists, through their association, the Council of State and Territorial Epidemiologists, and the CDC are working to specify the point at which notification of a disease should occur and what information should be supplied for each disease.
For example, reports of animal rabies should include the species of animal. For some other diseases, the patient's nationality might be valuable information.
A separate case reporting template is being developed for each disease.
The effort will result in faster public health responses to outbreaks, along with better understanding of how diseases spread, said John Abellera, a health scientist with the National Center for Public Health Informatics at CDC. It will allow more automated reporting and aggregation of the reports at CDC.
Abellera said CSTE is aiming to complete the effort in time for it to be adopted next summer at the organization's annual meeting. Work is finished for about half the diseases on the list, he said.
National notification of certain diseases within the United States began in 1893, when Congress authorized the predecessor of today's Public Health Service to collect the information from state and municipal authorities and publish it weekly. But reporting by states to the federal government has always been voluntary, and reporting in each state generally is governed by the laws of that state.
The current effort to standardize the notifications will require voluntary compliance by the states, but their involvement will help to ensure that happens. "Most people are supportive of this," Abellera said.
At the September meeting of the American Health Information Community, Dr. John Lumpkin, senior vice president of the Robert Woods Johnson Foundation, praised the project, saying, "The work the CDC has done with the Council of State and Territorial Epidemiologists to reach a common agreement of how to report these diseases and to move that, then, forward on the process of getting that into electronic basis represents a significant partnership between the states and CDC and leadership on the part of CDC."
The effort has been under way since before 2007, when the AHIC recommended development of a standard process for national notification "to support real-time nationwide public health event monitoring and rapid response management." The AHIC is the high-level health IT advisory committee of the Health and Human Services Department.
However, it accelerated in August when CSTE acquired the services of consultants who could devote more time to it and also enlisted the help of disease experts outside the public health informatics center, Abellera said.
Some members of Congress have urged improvements in preparedness for a potential bioterrorism attack on the nation.