Wisconsin's environmental public health tracking network: information systems design for childhood cancer surveillance.
In this article we describe the development of an information system for environmental childhood cancer surveillance. The Wisconsin Cancer Registry annually receives more than 25,000 incident case reports. Approximately 269 cases per year involve children. Over time, there has been considerable community interest in understanding the role the environment plays as a cause of these cancer cases. Wisconsin's Public Health Information Network (WI-PHIN) is a robust web portal integrating both Health Alert Network and National Electronic Disease Surveillance System components. WI-PHIN is the information technology platform for all public health surveillance programs. Functions include the secure, automated exchange of cancer case data between public health-based and hospital-based cancer registrars; web-based supplemental data entry for environmental exposure confirmation and hypothesis testing; automated data analysis, visualization, and exposure-outcome record linkage; directories of public health and clinical personnel for role-based access control of sensitive surveillance information; public health information dissemination and alerting; and information technology security and critical infrastructure protection. For hypothesis generation, cancer case data are sent electronically to WI-PHIN and populate the integrated data repository. Environmental data are linked and the exposure-disease relationships are explored using statistical tools for ecologic exposure risk assessment. For hypothesis testing, case-control interviews collect exposure histories, including parental employment and residential histories. This information technology approach can thus serve as the basis for building a comprehensive system to assess environmental cancer etiology.
Bureau of Health Information and Policy, Division of Public Health, Wisconsin Department of Health and Family Services, 1 West Wilson Street, Madison, WI 53702, USA. hantalp@dhfs.state.wi.us
Lawrence P
LP
Hanrahan
Henry A
HA
Anderson
Brian
B
Busby
Marni
M
Bekkedal
Thomas
T
Sieger
Laura
L
Stephenson
Lynda
L
Knobeloch
Mark
M
Werner
Pamela
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Imm
Joseph
J
Olson
D001331:Automation; D002648:Child; D002675:Child, Preschool; D019058:Community Networks; D003625:Data Collection; D004785:Environmental Pollutants / Q000506:poisoning*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007256:Information Systems / Q000458:organization & administration*; D008490:Medical Informatics; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology; D011159:Population Surveillance; D011634:Public Health; D012042:Registries / Q000706:statistics & numerical data*; D018570:Risk Assessment; D014922:Wisconsin / Q000453:epidemiology
D004785:Environmental Pollutants