NC DETECT: North Carolina Disease Event Tracking and Epidemiologic Collection Tool

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Background

In 1999, NCEDD was launched by the UNC Department of Emergency Medicine (UNC DEM) as a three year CDC-funded proof-of-concept project to address the need for secure, timely collection of emergency department data electronically in North Carolina from disparate hospital information systems. The goal was to provide useful, quality, near real-time data to a variety of public health and hospital-based users. The data collected were standardized using the CDC-developed Data Elements for Emergency Department Systems (DEEDS). At that time, the reporting focus was on a variety of public health surveillance uses, including injury, communicable diseases, occupational health, cardiovascular, as well as administrative and clinical benchmarking for participating hospitals. UNC Hospitals, New Hanover Regional Medical Center and Cape Fear Hospital participated in the pilot.
In 2002, NCEDD was funded by the NC Division of Public Health, through CDC bioterrorism monies, for rapid development in order to address the need for early event detection.
From 2002-2004, NCEDD remained a voluntary project, recruiting hospital participation statewide and eventually receiving data from 24 EDs across the state on a daily basis. Recruitment of hospitals involved the emphasis on the fact that daily collection of electronic emergency department data would have minimal impact on hospital resources, as well as require no additional data collection, entry or coding at the individual hospital level. Another important aspect of the project at this time was the effort to remain cost-effective through the use of off-the-shelf, non-proprietary tools.
In the spring of 2002, NCEDD introduced a secure web portal which provided standard and customized reports to authorized users.
In early 2003, in an effort to meet the newly imposed HIPAA regulations for privacy and security, a Data Use Agreement between participating hospitals “Covered Entity” and the NC Department of Health and Human Services and its agent, NCEDD, “Recipient” was put into place. The Data Use Agreement for a Limited Data Set (DUA) demonstrated compliance with HIPAA security and privacy rules for collection, transport of and access to health data.
In 2004, the North Carolina Disease Event Tracking and Epidemiological Collection Tool, NC DETECT (formerly called NC BEIPS, the North Carolina Bioterrorism and Emerging Infection Prevention System) was created to address the need for early event detection in North Carolina, using a variety of data sources including data from emergency departments, pre-hospital events, poison center calls and veterinary laboratories. NC DETECT is designed both to assist those in public health at all levels performing active surveillance as part of their day-to-day activities, as well as to detect signals across a variety of data sources that may otherwise go unnoticed until a much later point in time.
In 2005, a statewide mandate, the North Carolina Hospital Emergency Surveillance System (NCHESS), was put in place requiring all 113 EDs in North Carolina to submit select ED data elements to the state for public health surveillance. With NCHESS, the North Carolina Hospital Association (NCHA) and its subcontractor, Solucient, oversee the ED data collection from hospitals while UNC DEM continues to oversee the management, quality issues, storage and analyses of these data.