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Minnesota Company Provides Data for Public Health Surveillance

Donna Young

The Minnesota Department of Health has teamed with HealthPartners Inc., a managed care company based in Bloomington, Minn., to develop a syndrome surveillance system to detect possible bioterrorism attacks.

Heidi Kassenborg, a veterinarian and epidemiologist with Minnesota’s Bioterrorism Surveillance Unit, said the state received a $1-million bioterrorism preparedness and response grant from the Centers for Disease Control and Prevention (CDC).

The grant has been used to upgrade health department communications and information systems, buy new equipment for state laboratories, provide training for public health laboratory workers, and increase state-sponsored awareness programs for health care workers, Kassenborg said.

A portion of the CDC grant has gone toward funding the surveillance project with HealthPartners.

Under the project, the state extracts International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) data daily from HealthPartners’ information system.

ICD-9-CM is the official system of assigning codes to diagnoses and procedures associated with health care.

The health department downloads all cases where codes were entered for diagnoses of upper respiratory infection and flu-like symptoms, such as influenza, pneumonia, and bronchitis, Kassenborg said.

"There are 31 codes we use," she said. "Every time a code for one of those diagnoses are entered into HealthPartners' system, the system is programmed to automatically identify it for us."

Other patient data extracted by the state includes age, gender, postal zip codes, and the clinic where the patient was treated so the health department can track the magnitude of a disease outbreak.

HealthPartners physician James Nordin, M.D., M.P.H, said information for about 250,000 patients from 19 HealthPartners clinics in the Minneapolis-St. Paul metropolitan area is included in the system.

"That’s about 8 percent of the population, and that is a large enough sample to see if anything is going on," he said.

The state’s collaboration with HealthPartners for the project began in Jan. 2001, Kassenborg said. The state began downloading information from HealthPartner’s system this past July.

Having daily access to patient information is crucial to the state’s ability to quickly detect a public health threat, Kassenborg said.

"This wouldn’t work if we only got data every month or even once a week," she said. "Most doctor and hospital systems are designed for billing purposes, so patient information is downloaded on a monthly basis only. But we wanted something that was going to be as close to real time as possible."

Kassenborg said CDC would fund the project over the next five years.