CDC Upgrading IT to Gather Data from Hospitals

The Centers for Disease Control and Prevention (CDC) has quietly begun working with 31 hospitals in 10 large cities to create a system that can send real-time data feeds from emergency rooms to the CDC.

The program, which aims to help officials prepare for and respond to a pandemic of avian flu or a bioterrorist attack, will add 350 hospitals to the list this year.

To support the program, the Atlanta-based federal agency has been scrambling to upgrade its IT infrastructure so it's capable of receiving and analyzing the massive influx of data.

At this point, the CDC's systems are about a month away from being able to analyze incoming data from the initial 31 private hospitals during a catastrophic event, said Barry Rhodes, associate director for technology and informatics in the Division of Emergency Preparedness and Response at the CDC's National Center for Public Health Informatics. "The amount and rate of data streams to CDC is really unprecedented [compared with] what we have done in the past," he said.

As part of the IT upgrade, the CDC is building a real-time data warehouse that will support 20 TB to 30 TB of data over the next 12 to 18 months, Rhodes said.

The developers are using extract, transform, and load tools from Informatica Corp. to send data to the warehouse. They're also using business intelligence and data-mining tools from SAS Institute Inc. to analyze the information coming from the hospitals.

The hospitals are sending the data -- including patient symptoms, diagnoses, and geographic information -- to the CDC over the Internet as Web services messages using the ebXML standard to guarantee reliability and secure the exchange of the messages.

Beth Israel Deaconess Medical Center in Boston began sending feeds to the CDC on Dec. 21, about a month after the agency asked it to join the program, said John Halamka, CIO at the hospital's parent company, CareGroup Healthcare System. The hospital now sends the data to the CDC as Web services every 15 minutes, he said.

"This is really the first time in history there have been real-time hospital connections to public health [agencies]," said Halamka, who's also a Computerworld columnist. Beth Israel spent $50,000 to build its piece of the system, he added.

The CDC expects the emergency room data to provide it with "situational awareness" during a pandemic or bioterrorist attack, Rhodes said. "It is very important that we have information from hospitals on a real-time or near-real-time basis so we can get a snapshot of what is going on at that moment," he said.

The data feeds will be used to determine how many beds at a hospital are filled, how fast a disease is spreading, and if the CDC's interventions are working, he added. The CDC declined to identify the hospitals participating in the program.

The effort is part of the CDC's BioSense initiative, which was launched to improve the detection and situational awareness of national catastrophic events. The project will work in tandem with a program for early event detection that uses data from U.S. Department of Veterans Affairs and other U.S. Department of Defense healthcare providers to determine whether an event is occurring, according to Rhodes. The event-detection program is also part of the BioSense initiative. Eric Brown, an analyst at Forrester Research Inc. in Cambridge, Mass., said that BioSense will replace the current paper-based process under which hospitals first report anomalies to state public health agencies before they're forwarded to the CDC, which ends up with "stale" data.

"In healthcare, there has not been a coordinated effort of this size to gather real-time clinical get a real-time snapshot of healthcare in the U.S.," Brown said.

"Avian bird flu is not the first time the public has been gripped with panic of a pandemic," he continued. "But we have never been able to take this type of technology-driven response to it."

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