Statewide system of electronic notifiable disease reporting from clinical laboratories - Comparing automated reporting with conventional methods
Statewide system of electronic notifiable disease reporting from clinical laboratories - Comparing automated reporting with conventional methods
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DOI：
10.1001/jama.282.19.1845
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发表时间：
1999-11-17
影响因子：
120.7
通讯作者：
Jernigan, D
中科院分区：
文献类型：
--
作者：
Effler, P;Ching-Lee, M;Jernigan, D
背景 法定疾病监测对于快速识别和应对疫情至关重要，从而预防进一步的疾病。已提议将临床实验室的报告自动化，以减少漏报和延误。目的 将原型电子报告系统与传统实验室报告的及时性和完整性进行比较。设计 对 1998 年 7 月 1 日至 12 月 31 日期间州卫生部门收到的 5 种情况的基于实验室的报告进行了审查。使用捕获-再捕获方法估计每个报告系统覆盖的完整性。设置夏威夷州的三个全州私人临床实验室。主要结果指标按报告系统、实验室和病原体划分的收到报告的数量和日期；数据字段的完整性。 结果 总共识别出 357 份独特的疾病报告； 201 份（56%）仅通过自动化电子系统收到，32 份（9%）仅通过传统系统收到，124 份（35%）通过两者均收到。因此，电子报告使报告数量增加了 2.3 倍（95% 置信区间 [CI]，2.0-2.6）。电子报告比传统报告平均早 3.8 天（95% CI，2.6-5.0）天到达。在纸质和电子格式共有的 21 个数据字段中，电子报告的 12 个字段和传统系统的 1 个字段的完整度明显更高。电子报告的估计覆盖完整性为 80%（95% CI，77%-82%），而传统系统的覆盖完整性为 38%（95% CI，37%-39%）。 结论 在本次评估中，电子报告使收到的实验室报告总数增加了一倍多。平均而言，电子报告更及时、更完整，这表明电子报告最终可能有助于更快速、更全面地制定疾病控制措施。
Context Notifiable disease surveillance is essential to rapidly identify and respond to outbreaks so that further illness can be prevented. Automating reports from clinical laboratories has been proposed to reduce underreporting and delays.Objective To compare the timeliness and completeness of a prototypal electronic reporting system with that of conventional laboratory reporting.Design Laboratory-based reports for 5 conditions received at a state health department between July 1 and December 31, 1998, were reviewed. Completeness of coverage for each reporting system was estimated using capture-recapture methods.Setting Three statewide private clinical laboratories in Hawaii.Main Outcome Measures The number and date of reports received, by reporting system, laboratory, and pathogen; completeness of data fields.Results A total of 357 unique reports of illness were identified; 201 (56%) were received solely through the automated electronic system, 32 (9%) through the conventional system only, and 124 (35%) through both. Thus, electronic reporting resulted in a 2.3-fold (95% confidence interval [CI], 2.0-2.6) increase in reports. Electronic reports arrived an average of 3.8 (95% CI, 2.6-5.0) days earlier than conventional reports. Of 21 data fields common to paper and electronic formats, electronic reports were significantly more likely to be complete for 12 and for 1 field with the conventional system. The estimated completeness of coverage for electronic reporting was 80% (95% CI, 77%-82%) compared with 38% (95% CI, 37%-39%) for the conventional system.Conclusions In this evaluation, electronic reporting more than doubled the total number of laboratory-based reports received. On average, the electronic reports were more timely and more complete, suggesting that electronic reporting may ultimately facilitate more rapid and comprehensive institution of disease control measures.