Massachusetts Incorporates Technology From AHRQ-Funded Program on Emergency Preparedness
The Massachusetts Department of Public Health (MDPH) is using technology from the Automated Epidemiologic Geotemporal Integrated Surveillance (AEGIS) system, a project supported through AHRQ's Bioterrorism and Emergency Preparedness Research Program.
AEGIS, which acquires and processes clinical data to detect abnormal patterns of disease in the population, is a leading-edge population monitoring system. Eight Massachusetts hospitals provide data for the state. It was developed under the leadership of Dr. Kenneth D. Mandl at the joint informatics program of the Harvard-MIT Division of Health Sciences and Technology and Children's Hospital in Boston.
In 2003, the AEGIS technology was successfully transferred to MDPH. The Commonwealth now contracts with the original investigators to run the system, as well as to develop it further.
Frontline clinicians are generally better at recognizing individual cases rather than patterns of cases over time and across a geographical region. AEGIS augments the capabilities of the alert clinician by monitoring these larger trends.
While traditional surveillance systems rely on voluntary reports from providers to acquire data, AEGIS acquires data continuously through fully automated routines. Real-time population health monitoring technology is useful not only for the detection of bioterrorism, but also for general public health monitoring, clinical medicine, quality improvement, patient safety, and research.
An open-source version of AEGIS is being rolled out later in 2005. Since the software and code will be freely available, other departments of public health and researchers can use and adapt it. According to the MDPH Director of Informatics James Daniel, MPH, "AEGIS protects patient privacy; it de-identifies patient data while automatically alerting health authorities about the potential risk level of any incident."
MDPH is rapidly expanding the network of participating hospitals and clinics, especially in the rural areas of the state. In addition, there is potential to expand the AEGIS system to other states. "In the future, the biggest issue in an alert situation," says Daniel, "is being able to get into de-identified medical charts and share that information with others."
Mandl K, Overhage M, Wagner M, et al. Implementing syndromic surveillance: A practical guide informed by the early experience. Journal of the American Medical Informatics Association. 2004: 11 (2):141-150. (Contract No. 290-00-0020 and 290-00-0009)