Expanding the scope
Syndromic surveillance tracks bioterror,
day-to-day emergencies
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Pediatrician-in-Chief
Gary Fleisher, MD, explains how ED Scope, allows
the Emergency Deptartment to track signs of bioterrorism.
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Clinicians in Children’s Hospital Boston’s Emergency
Department (ED) who helped develop a software program
to track signs of bioterrorism have found that it also provides
valuable information for predicting day-to-day emergencies.
Known as EDScope,
the project began last summer as part of the hospital’s continuing
efforts at “syndromic surveillance,” or surveying hospitals
and clinics for clusters of particular diseases that may signal
a bioterrorist attack.
“The challenge has always been that people come into the
ED individually, not all at once,” says Michael
Shannon, MD, MPH, interim chief of Emergency Medicine.
“So it was hard to determine if there was a change in the
pattern of a given set of symptoms. EDScope lets us see those
patterns and identify potential problems before they get out of
hand.”
The software was developed by the hospital’s Informatics
Program, implemented by the Information Services Department, and
gives ED staff a real-time look at the types of problems treated
on a given day. The symptoms of each patient admitted to the ED
are entered into the computer in 14 basic categories (such as
rash or meningitis). Physicians, nurses and other staff then can
consult a computerized readout—which is updated every 15
minutes—that shows all the activity in the ED that day and
for the previous week.
The system then compares the data for a given day with information
from the more than 500,000 Children’s ED visits in the last
11 years. If the computer analysis finds, for example, that more
people have been admitted for respiratory symptoms than is normal
for that time of the year and day of the week, a red flag alerts
staff that a pattern may be developing.
Since the system went into use, Dr. Shannon and his ED colleagues
have also found they can use the information to predict more common
emergency room activities with high accuracy. “We’ve
always known that we got more trauma patients in the summer and
patients with the flu in the winter,” says Dr. Shannon. “But
with EDScope, we can predict what specific types of patients we’re
likely to get on any given day next month or next April.”
Dr. Shannon would like to explore the use of the software at
other hospitals in the area so the data is that much more useful.
“Right now there’s no place else in the country that
can do this, but our goal is to share information with other hospitals
and create a network for identifying disease patterns.”
