Evaluation of an electronic general-practitioner-based syndromic surveillance system--Auckland, New Zealand, 2000-2001.

INTRODUCTION During 2000 and 2001, Auckland Regional Public Health Service piloted a general-practitioner-based syndromic surveillance system (GPSURV). OBJECTIVES The pilot evaluated data capture, the method used to distinguish initial from follow-up visits, the definition of denominators, and the external validity of measured influenza-like illness trends. METHODS GPSURV monitored three acute infectious-disease syndromes: gastroenteritis, influenza-like illness, and skin and subcutaneous tissue infection. Standardized terms were used to describe the syndromes. Data were uploaded daily from clinics and transferred to a database via a secure network after one-way encryption of patient identifiers. Records were matched to allow the distinction of follow-ups from first visits, based on between-visit intervals of </=8 weeks. Denominator populations were based on counts of unique patients treated at participating clinics during the previous 2 years. Record completion was examined by using before-and-after surveys of self-assessed standardized-term recording. Between-visit intervals were counted for matching records and alternative denominators were calculated on the basis of different observation periods. Weekly influenza-like illness rates were compared with rates generated by an alternative system. RESULTS Physicians' self-reported recording compliance was highest for skin and subcutaneous tissue infection (71%) and lowest for influenza-like illness (48%). Initial visits had 18%-19% greater compliance than follow-up visits. The number of physicians reporting increasing compliance during the pilot was greater than the number reporting decreases for all conditions. Comparison of data with an independent influenza-like illness surveillance system indicated a close agreement between the two data series. CONCLUSIONS These results indicate that incidence of acute syndromes can be monitored, at least as successfully as a manual system, by using standardized clinical-term data from selected general-practice clinics. The provision of feedback reports appears to have a limited but positive effect on data quality.

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