Nedss: What Do You Think Would Be

NEDSS: What do you think would be three hurdles to successful implementation (at CDC and in the state of Mississippi)?

"The National Electronic Disease Surveillance System (NEDSS) is a secure online framework that allows healthcare professionals and government agencies to communicate about disease patterns and coordinate national response to outbreaks…. The CDC mandates that hospitals, clinics and state health agencies all adopt NEDSS standards so that the speed, accuracy, standardization and viability of data about diseases are improved" (National Electronic Disease Surveillance System (NEDSS, 2012, Tech Target). The goal of NEDSS is seamless integration and coordination between state and federal authorities when combatting sudden epidemics (such as H1N1) or long-standing chronic diseases that must be addressed over time, such as obesity.

One problem with implementing such a system "is the delay experienced from incident awareness, through laboratory testing and ultimately to public health investigation" (Tracking silent killers, 2012, Center for Digital Government). Diseases are not always quickly identified and identified as forming an existing 'pattern.' Healthcare workers at the beginning of an epidemic may not be able to spot the 'signs' of an outbreak and record the data in a manner so that the connection can be traced from one carrier to another.

Another technical problem is "a lack of uniformity and collaboration creates roadblocks in states' efforts to become more effective public health watchdogs" as even states with existing electronic surveillance systems do not necessarily use uniform methods (Tracking silent killers, 2012, Center for Digital Government). This means that drawing connections between patterns of disease spread across state lines may be challenge for states such as Mississippi if the data-tracking system is different from that of neighboring states. "Even CDC officials acknowledge that NEDSS requires a major effort on the part of the states, partly because it involves more complex data than they had to work with in the past. Before, infectious disease cases were reported individually and didn't automatically get grouped in a database. With NEDSS, states will combine their reports into integrated data repositories, giving users a fuller picture of what is happening regionally and nationally -- but also imposing new data-management requirements" (Weiss 2008:2). Not all states may have the same technical resources and the CDC has limited power to impose restrictions upon states to change.

A final difficulty is variability in care from state to state. Inadequate health delivery systems mean that data may be incomplete because residents lack ready access to care. "Mississippi continues to lead the nation in infant death rate, teenage pregnancy, births to unwed mothers, and sexually transmitted diseases (especially syphilis)" (Mississippi State Department of Health, 2004, State Health Plan FY- 2004: IV). Poverty, lack of education, and poor health habits passed from generation to generation may mean that diseases spreading in the state may be overlooked or be difficult to diagnose because they exist as multifactorial problems, due to lack of regular preventative treatment or because the patient's other lifestyle issues mask the presentation of the specific illness to the healthcare provider.