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Usefulness of data from primary care for real-time surveillance of diseases.

Nielen, M.M.J., Schellevis, F.G., Verheij, R.A. Usefulness of data from primary care for real-time surveillance of diseases. European Journal of Public Health: 2006, 16(Suppl. 1) 20. Abstract. 14th Eupha conference "Politics, Policies and /or the Public's Health", Montreux, 16-18 November 2006.
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Background: The increased threat of bioterrorism and the outbreaks of new infectious diseases require rapid identification of clusters of illness. The increased availability of electronic data in health care makes real-time surveillance of diseases possible. Therefore, we investigated the possibilities of using electronic medical records from primary care for real-time surveillance in The Netherlands. Methods: Real-time surveillance systems were identified by a search in Medline. The selected surveillance systems were evaluated using criteria such as representativeness, validity, and timeliness. The characteristics of these systems were compared with those of The Netherlands Information Network of General Practice (LINH). Results: A total of 188 articles were reviewed; 23 real-time surveillance systems were found. Three surveillance systems used electronic data from GPs. Four systems included data representative for the general population. Ten surveillance systems described the coverage of the target population, which varied between 10 and 100%. Only one system had information available about its validity to detect a possible outbreak. Timeliness varied between the systems (<24 h up to a couple of weeks). The LINH network covers a representative sample of 3% of the Dutch population. Validity to detect outbreaks is not yet studied. Morbidity data can be reported on a weekly basis. Conclusions: Primary care based systems can be used and are being used for real-time surveillance. However, in The Netherlands, the coverage of LINH is low compared with existing real-time surveillance systems elsewhere. Therefore, data from LINH can only be used when a particular disease is spread nationwide with a high incidence. For real-time surveillance of rare diseases, the number of participating GPs needs to be increased. Alternatively, a system with fast recruitment of GPs after the identification of a regional outbreak is needed. The feasibility of these two scenarios will be discussed. (aut. ref.)