Incorporating vaccine-preventable disease surveillance into the National Health Information Network: leveraging children's hospitals.
OBJECTIVE
Development of national biosurveillance systems to advance regional and national data exchange among sites of clinical care and public health authorities is a top federal priority, creating the opportunity to develop a unified national network for tracking and responding to cases of vaccine-preventable diseases. The purpose of this study was to assess the current practice and feasibility of developing a nationwide network of children's hospitals to conduct surveillance for vaccine preventable diseases.


METHODS
In 2004-2005, Web-based surveys were sent to 506 key hospital personnel from 119 pediatric hospitals, identified by the National Association of Children's Hospitals and Related Institutions. Surveys measured attitudes toward public health initiatives, willingness to join a surveillance network of children's hospitals, knowledge of mandated reporting requirements, methods of disease detection and reporting, and data sources available for surveillance.


RESULTS
A total of 395 (78%) respondents from 119 hospitals completed the survey. Surveillance at pediatric hospitals is largely passive and driven by unreimbursed efforts of infection control staff. It is vulnerable to missing cases that occur in the outpatient setting and are diagnosed clinically without laboratory confirmation or are never diagnosed by clinicians. Nearly 90% of hospital leaders are interested in participating in public health programs, and most are interested in a national network to conduct active surveillance for vaccine-preventable diseases, dependent on the provision of sufficient funding. Pediatric hospitals store records relevant to surveillance in an electronic fashion accessible to query, but <20% of these hospitals use automated methods to report cases of disease.


CONCLUSIONS
There is both the will and capability to create a robust active pediatric hospital-based reporting system for vaccine preventable diseases. This effort would dovetail well with the national priority to bolster surveillance, as well as with the goal of reducing morbidity and mortality from vaccine-preventable diseases.
Fine
Andrew M
AM
Division of Emergency Medicine, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115, USA. andrew.fine@childrens.harvard.edu
Goldmann
Donald A
DA
Forbes
Peter W
PW
Harris
Sion K
SK
Mandl
Kenneth D
KD
D002648:Child; D004196:Disease Outbreaks; D019983:Guideline Adherence; D006306:Health Surveys; D006751:Hospital Information Systems; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D017053:Infection Control / Q000706:statistics & numerical data*; D007255:Information Services; D020407:Internet; D019221:Mandatory Reporting; D011159:Population Surveillance; D016730:Program Development; D011634:Public Health; D014481:United States; D014611:Vaccination; D014612:Vaccines
D014612:Vaccines