Tracking Outbreaks

Today's headlines warn of the potential for a worldwide pandemic from the avian flu or some other virus. If that happens, hospital emergency rooms would be the first line of defense. But most ERs aren't equipped to judge an outbreak's scope and severity.

That's beginning to change. Earlier this month, for example, North Carolina detailed plans to complete by April a statewide monitoring system in 109 emergency rooms to give early warning of disease outbreaks.

Emergency Medical Associates, a nonprofit, physician-owned organization that manages and staffs emergency rooms in 17 New Jersey and New York hospitals, is a pioneer in tapping into ER patient data to detect and monitor disease outbreaks. EMA's emer- gency rooms treat, on average, 2,800 patients every day. The group collects data from hospital clinical and billing systems and analyzes it to spot trends such as spikes in the number of ER patients complaining of respiratory or gastrointestinal problems that might indicate a bigger problem.

EMA's Emergency Medicine Analysis & Reporting System, which includes a data warehouse with data from 6.5 million patient visits and reports and dashboards developed using Business Objects SA software, provides physicians and ER managers with data that helps them identify operational bottlenecks, monitor the implementation of best practices, and develop more-efficient staffing plans. If more health-care providers used such a system, the quality of patient care would rise and health-care costs would fall, says Jonathan Rothman, EMA's data-management director. "We hope one day the things we're doing in business intelligence are done by all health-care providers," he says.

EMA ingeniously taps into that data to detect and track disease outbreaks. The system flags references in patient admittance and billing records to a handful of key "patient-complaint" words to calculate the number of patients with respira- tory or gastrointestinal problems, rashes, blood poisoning, a cold, fever, asthma, or the flu. Doctors will spot the first cases of any outbreak of a disease such as avian flu, Rothman says, but EMA's system will help authorities monitor its development and track its spread.

Several times a week, Rothman E-mails data to a long list of health authorities, doctors, and medical researchers for review. "My job is to get the word out," he says. The system successfully detected a flu outbreak last year, Rothman says. This month Business Objects awarded Rothman and EMA its annual Business Intelligence Visionary Award.