title: Connecting health departments and providers: syndromic surveillance's last mile.
abstract: BACKGROUND
  A critical need exists for mechanisms to identify and report acute illness clusters to health departments. The Massachusetts Department of Public Health (MDPH) works with partner organizations to conduct syndromic surveillance. This effort is based on CDC's Health Alert Network program and includes automated generation and notification of signals and a mechanism to obtain detailed clinical information when needed.
  
  
  METHODS
  Syndromic surveillance partners collect emergency department and ambulatory care data. The principal communications platform between syndromic surveillance partners and MDPH is the Massachusetts Homeland and Health Alert Network (HHAN). This Internet-based application serves as a portal for communication and collaboration and alerts predefined groups of users involved in emergency response. Syndromic surveillance partners' systems report to HHAN by using Public Health Information Network Messaging System events that meet thresholds selected by MDPH. Cluster summaries are automatically posted into a document library. HHAN notifies users by electronic mail, alphanumeric pager, facsimile, or voice communications; users decide how they want to be notified for each level of alert. Discussion threads permit real-time communication among all parties.
  
  
  RESULTS
  This automated alert system became operational in July 2004. During July-December 2004, HHAN facilitated communication and streamlined investigation of 15 alerts.
  
  
  CONCLUSIONS
  The system allows rapid, efficient alerting and bidirectional communication among public health and private-sector partners and might be applicable to other public health agencies.
authors.affiliation: Bureau of Communicable Disease Control, Massachusetts Department of Public Health, State Laboratory Institute, Boston, Massachusetts 02130, USA. James.Daniel@state.ma.us.
authors.forename: James B
authors.initials: JB
authors.lastname: Daniel
authors.forename: D
authors.initials: D
authors.lastname: Heisey-Grove
authors.forename: P
authors.initials: P
authors.lastname: Gadam
authors.forename: W
authors.initials: W
authors.lastname: Yih
authors.forename: K
authors.initials: K
authors.lastname: Mandl
authors.forename: A
authors.initials: A
authors.lastname: Demaria
authors.forename: R
authors.initials: R
authors.lastname: Platt
mesh_terms: D004189:Disaster Planning; D004196:Disease Outbreaks / Q000517:prevention & control*; D006801:Humans; D033183:Interdisciplinary Communication; D008404:Massachusetts; D011159:Population Surveillance / Q000379:methods*; D017149:Private Sector; D040442:Public Health Informatics / Q000295:instrumentation*; D017150:Public Sector