System Helps Doctors Spot Unusual Health TrendsSystem Helps Doctors Spot Unusual Health Trends

By studying information in an online database shared by six hospitals, New Mexico health officials learned that Type B influenza was the most common strain last winter. Armed with that information, doctors began waiting for a lab test before starting an expensive drug treatment, because Type B didn't respond to that medication.

Battling the annual flu bug and dealing with a crisis such as the anthrax infections have a lot in common. Researchers at Sandia and Los Alamos national laboratories in Albuquerque, N.M., developed the software and expect a $1 million grant to cover the hardware costs of putting it in 150 hospitals in five states.

Using the Web to report symptoms linked to infectious diseases is designed to heal a major vulnerability in the U.S. health-care system: Information is generally isolated hospital by hospital, and an unusual disease is only reported once the diagnosis is confirmed. That adds to the time it takes to spot a trend of an illness. This system focuses on symptoms and uses a rules-based software program to alert doctors and the state Health Department Offices in Santa Fe, N.M., when there's a spike in a particular condition.

"If one doctor in one emergency room saw one patient with unusual symptoms, he might not be too concerned," says Reynolds Salerno, a senior member of the technology staff at Sandia. "But if the public-health officials noticed that five doctors in different hospital saw five patients with the same unusual symptoms, it would be a red flag."

The system, called Rapid Syndromic Validation Project, works this way: Emergency room physicians enter a patient's demographic information, such as age, ZIP code, and sex, plus symptoms such as fever, rash, and blood counts into a networked PC. The information can be entered in less than a minute and is sent to local public-health officials, who can monitor patterns of similar symptoms being reported by other physicians in a region. Doctors also have access to trend data, such as recent spikes in similar symptoms in a certain area. A physician who suspects an emergency also can notify public-health officials immediately via an icon that calls, E-mails, faxes, or pages an official on call.

The Java-based validation project is built from software developed by the Los Alamos National Laboratory to connect rural New Mexico hospitals to the Internet. (The open-source software is available free at SourceForge .net.) The thin-client system requires a PC in the hospital, a Web connection, and a Web server.

The project isn't foolproof. It takes extra effort from busy emergency-room staff. It takes monitoring by public-health officials who need to know the symptoms of a disease they might never have seen before. Another version of the software, called Be Safer, is in development to be more user-friendly and able to spot more trends. However, the New Mexico test already has had some success in combating influenza and hepatitis A.

Sandia officials say such a system not only would help health-care officials react to a biological attack but would also serve as a deterrent. If the health-care system looks prepared to quickly locate and isolate a biological attack, it makes a less-tempting target. To get there, the industry needs to share information more quickly. Says Salerno, "Every hour counts."