title: We can have it all: improved surveillance outcomes and decreased personnel costs associated with electronic reportable disease surveillance, North Carolina, 2010.
abstract: OBJECTIVE
  We assessed the timeliness, accuracy, and cost of a new electronic disease surveillance system at the local health department level. We describe practices associated with lower cost and better surveillance timeliness and accuracy.
  
  
  METHODS
  Interviews conducted May through August 2010 with local health department (LHD) staff at a simple random sample of 30 of 100 North Carolina counties provided information on surveillance practices and costs; we used surveillance system data to calculate timeliness and accuracy. We identified LHDs with best timeliness and accuracy and used these categories to compare surveillance practices and costs.
  
  
  RESULTS
  Local health departments in the top tertiles for surveillance timeliness and accuracy had a lower cost per case reported than LHDs with lower timeliness and accuracy ($71 and $124 per case reported, respectively; P = .03). Best surveillance practices fell into 2 domains: efficient use of the electronic surveillance system and use of surveillance data for local evaluation and program management.
  
  
  CONCLUSIONS
  Timely and accurate surveillance can be achieved in the setting of restricted funding experienced by many LHDs. Adopting best surveillance practices may improve both efficiency and public health outcomes.
authors.affiliation: Erika Samoff, Lauren DiBiase, Mary T. Fangman, and Pia D. M. MacDonald are with the Institute for Public Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill. Aaron T. Fleischauer is with the Centers for Disease Control and Prevention and North Carolina Division of Public Health, Raleigh. Anna E. Waller is with the Carolina Center for Health Informatics, Department of Emergency Medicine, University of North Carolina, Chapel Hill.
authors.forename: Erika
authors.initials: E
authors.lastname: Samoff
authors.forename: Lauren
authors.initials: L
authors.lastname: Dibiase
authors.forename: Mary T
authors.initials: MT
authors.lastname: Fangman
authors.forename: Aaron T
authors.initials: AT
authors.lastname: Fleischauer
authors.forename: Anna E
authors.initials: AE
authors.lastname: Waller
authors.forename: Pia D M
authors.initials: PD
authors.lastname: MacDonald
mesh_terms: D001331:Automation; D017046:Cost Savings / Q000191:economics*; D018563:Disease Notification / Q000379:methods*; D004196:Disease Outbreaks; D006801:Humans; D007753:Laboratories; D009111:Local Government; D009657:North Carolina; D062486:Public Health Surveillance / Q000379:methods*; D036301:Qualitative Research; D011795:Surveys and Questionnaires