2014.ISDS.Abstracts.Final.pdf


ISDS Annual Conference Proceedings 2014. This is an Open Access article distributed under the terms of the Creative Commons Attribution-
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ISDS 2014 Conference Abstracts

Improving Local Non-Communicable Disease 
Surveillance within a Changing Data Environment
Allison Young*1, Mike D. Fliss1 and Amy Ising2

1Orange County Health Department, Hillsborough, NC, USA; 2University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

Objective
This project aims to fill a growing county-level health data gap 

through the development of a low-cost, Excel-based surveillance tool. 
This prototype utilizes emergency department data (ED) collected by 
NC DETECT, a state-wide syndromic surveillance system, in order 
to visualize, monitor, and compare annual local health indicators 
for use in local decision making. In this way, the project aims to 
increase noncommunicable disease surveillance capacity and improve 
situational awareness within North Carolina local health departments 
(LHDs).

Introduction
LHDs are operating in a changing data environment. As household 

telephone use declines, national surveys are not sampling large 
enough populations to report representative local health statistics.1 As 
a result, reliable indicators from surveys such as the Behavioral Risk 
Factors Surveillance Survey (BRFSS) are becoming scarce (Figure). 
Soon, these indicators may not be sufficient for county assessments. 
NC DETECT primarily uses data from emergency departments, the 
Carolinas Poison Center, and the Pre-hospital Medical Information 
System (PreMIS) to identify outbreaks and facilitate emergency 
response.2 However, while built to aggregate “real-time” data, NC 
DETECT also provides a source for rich, long-term indicators. The 
challenge for LHDs is that they may not have the knowledge, training, 
or technical assistance needed to fully utilize NC DETECT services.1 
This project capitalizes on available human, organizational, and 
technical resources to increase LHD situational awareness3 and to 
demonstrate the usefulness of both “real-time” surveillance data as 
aggregate indicators of county health, and of low-cost prototyping 
using Excel’s more advanced Business Intelligence (BI) features.

Methods
This initiative leverages NC DETECT’s surveillance system 

as both a tool for collecting data and a platform for disseminating 
reports. LHDs may already register for access to NC DETECT and 
request customized reports. However, visualizing indicators in a web-
based system directly can be difficult and costly. An Excel template 
is in development that will provide users with the ability to select 
common health indicators, pull annual trend data, and visualize data 
through meaningful reports. A preliminary list of available indicators 
includes annual ED visits for the following: asthma; diabetes; STDs; 
drug overdose; acute alcohol poisoning; other poisonings; motorcycle, 
pedal-cyclist, and pedestrian injuries; other injuries; cancer; stroke; 
cardiovascular disease; obesity; substance abuse; and mental health.

Results
This tool requires low epidemiological expertise and is easily 

shared. Because NC DETECT currently houses 166 registered LHD 
users, this tool has broad reach and the potential to impact the overall 
noncommunicable disease surveillance capacity of North Carolina at 
the local level.

Conclusions
This tool models one solution to a changing data environment. The 

reports created by this tool can be used by LHDs to track indicators 
that are challenging to find in other places. In this way, the tool will 
improve local situational awareness and equip LHDs with the ability 
to make informed policy and programmatic decisions.

Keywords
noncommunicable disease surveillance; local health departments; 
dashboards; situational awareness; low cost prototyping

Acknowledgments

This study was supported in part by an appointment to the Applied 
Public Health Informatics Fellowship Program administered by CSTE 
and funded by the Centers for Disease Control and Prevention (CDC) 
Cooperative Agreement 3U38-OT000143-01S1. NC DETECT is funded 
with federal funds by the North Carolina Division of Public Health, Public 
Health Emergency Preparedness Grant (PHEP), and managed through a 
collaboration between NC DPH and the UNC Department of Emergency 
Medicine Carolina Center for Health Informatics.

References

1. Luck J, Chang C, Brown R, and Lumpkin J. Using local health
information to promote public health. Health Affairs. 2006; 25(4):979-
91.

2. North Carolina Disease Event Tracking and Epidemiologic Collection
Tool [Internet]. Chapel Hill (NC); c2004-2014; [cited 2014 Sept 2].
Available from http://ncdetect.org

3. Endsley M R, and Garland D J, editors. Situational Awareness Analysis
and Measurement. Mahwah, NJ: Lawrence Erlbaum Associates: 2000. 
408p.

*Allison Young
E-mail: ayoung@orangecountync.gov    

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * (1):e177, 201