Public Health Watch 2Public Health Watch 2

In the race to identify potential threats to public health, including those associated with bioterrorism, the problem isn't that there's not enough data. It's that existing data isn't aggregated fast enough, distributed to the people who can act on it, or presented in a way that anomalies and patterns are easily detectable.

That's the premise behind a technology project under way at MedStar Health, a health-care provider that operates seven hospitals in the Washington, D.C., area. About four years ago, tech-savvy doctors at MedStar developed a biosurveillance system that's used to detect a rise in symptoms among its patients that could signal anything from a flu epidemic to an anthrax attack. Now the team is aiming higher by designing a system that pulls in more kinds of data and presents it in dramatically different ways.

The goal is to create what Craig Feied, director of MedStar's Institute for Medical Informatics, calls "situational awareness," which he describes as a dynamic, real-time view of an entire region's health status-something akin to a weather map but where clouds might represent a virus. Two of the hospitals in the MedStar network, Washington Hospital Center and Georgetown University Medical Center, were awarded a $6.5 million grant last fall from the National Institutes of Health's National Library of Medicine to develop the idea.

Called Project Sentinel, the initiative has three major objectives. The first, now under way, is to pull in more types of information, including agricultural data, increases in certain types of phone calls, the movement of over-the-counter medicine, and employee absenteeism and veterinary reports. "Pets are the canaries in the coal mine," says Feied, a doctor with years of emergency-room experience, though no longer practicing.

Next, Feied and colleague Dr. Mark Smith, chairman of the Department of Emergency Medicine for the two hospitals and a onetime computer-science student at Stanford University, and their associates plan to experiment with advanced visualization tools to analyze all that data. And they're anticipating ways the applications they develop can ride over a next-generation Internet.

The Sentinel system feeds information into the District of Columbia's Department of Health. Sentinel isn't the only biosurveillance system under development by federal agencies and health-care providers, but Feied believes that MedStar's 35-terabyte database of clinical information is one of the largest and fastest involved in such a project.