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Bioterrorism Alerts: Immune Systems

Health officials are working toward a sophisticated IT network that could detect the early warning signs of bioterrorism, whether it's inhalation anthrax, smallpox, pneumonic plague or something else entirely.

By Sarah D. Scalet

August 01, 2003 — CSO — Fever. Nausea. Vomiting. Diarrhea.

At first, bioterrorism—whether it's inhalation anthrax, smallpox, pneumonic plague or something else entirely—will probably feel like the flu. You'll be miserable, but you probably won't be alarmed. You'll go to your local drugstore, clinic, maybe an emergency room. Doctors in one place or another might notice a small uptick in patients with flulike symptoms. But no one will see the pattern. Until people start dying.

That is, unless a sophisticated computer network could transmit and integrate patient information in real-time so

that health officials could see what was happening across hundreds, if not thousands, of facilities. And that's just what legions of technologists and clinicians in public health departments, hospitals, laboratories and pharmacies are trying to develop right now.

"The systems are being defined and created as we speak," says Rosemary Nelson, chairman of National Preparedness and Response, a new bioterrorism task force created by the Healthcare Information Management and Systems Society (HIMSS). If such a network existed, health officials could sound the alarm in that precariously short window of time when the spread of the disease could be stopped.

The system could be information technology's finest hour, saving lives as well as money. Even without a bioterrorism attack, a surveillance system would be useful in detecting the early stages of any disease, such as the recent outbreak of the mysterious ailment called SARS, or severe acute respiratory syndrome. Such a system could also help lay the groundwork for a long-desired standardization of electronic medical records, which would significantly reduce errors in patient care and save substantial amounts of time and money.

But if the pieces don't come togetheror if they do but in the process erode the concept of patient confidentialitythen that could be IT's greatest failure.

"[Technology] has so much potential use in bioterrorism and health care, but the word is potential," says Dr. Eduardo Ortiz, a senior fellow with the Agency for Health Care Research and Quality at the U.S. Department of Health and Human Services, which in August 2002 released a 354-page report about how IT could be used for bioterrorism preparedness and response. "We're not there yet; we're not even close," he says.

Since the anthrax attacks in Connecticut, Florida, New York and Washington, D.C., definite progress has been made in creating an effective early warning system for bioterrorism. But wildly disparate computer systems, disconnected and often overlapping projects, and a lack of industry standards still stand in the way of creating the kind of network that can save lives.