IOM: Nationwide surveillance programs could help curb chronic disease
While surveillance programs focused on chronic diseases are effective, these types of systems currently do not exist and do not operate in a coordinated manner to integrate and report current chronic disease data across the U.S. Thus, the National Heart, Lung, and Blood Institute and the Centers for Disease Control and Prevention turned to the Institute of Medicine (IOM) to create a framework for a national surveillance system, and the institute concluded that surveillance systems can improve the monitoring and tracking of chronic diseases.
“Without a national surveillance system, the gaps in current monitoring approaches will continue to exist, making it more difficult to track the nation’s health status despite advances in technology and data collection,” according to the IOM report brief, titled "A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases."
“Chronic diseases, such as cardiovascular disease and chronic lung disease are common and costly, yet they also are among the most preventable health problems,” wrote the brief put forth by the IOM study committee appointed to develop frameworks for building a chronic disease surveillance system.
The committee said that such a system must have the capability to provide data on disparities of diseases by race, ethnicity, socioeconomic status and geographic region, along with data on disease risk factors and clinical care delivery.
During its research, the IOM committee outlined newer surveillance tools including EHRs, which can help to capture care events and processes. “Expanding the use of EHRs in surveillance will have challenges, including the relatively low numbers of hospitals and practices now using the technology,” the brief stated. “But use of EHRs is expected to expand as healthcare reforms advance, necessitating their inclusion when planning for a national surveillance system.”
In addition, IOM said that coupling patient health data with other larger health databases can help facilitate population surveillance. “Although these sources have yet to be fully assessed, the potential is great that some, if not all, of them may complement and extend chronic disease surveillance efforts, although privacy issues must be addressed.”
The IOM committee concluded that the Department of Health and Human Services (HHS) should take the lead in these efforts, as it is already positioned to provide funding and conduct surveillance efforts as well as bring together stakeholders from public and private sectors.
The institute said that the future system that should be developed by HHS to include:
“A robust surveillance system will serve as a benchmark for clinicians treating patients with cardiovascular and chronic lung diseases. It will help in monitoring, evaluating, and improving policies, programs and services and in directing the placement of resources and it will provide a stronger basis for advocacy and education,” IOM noted.
The framework put forth by the IOM committee could serve as a building block for a national surveillance system to track chronic diseases.
“Without a national surveillance system, the gaps in current monitoring approaches will continue to exist, making it more difficult to track the nation’s health status despite advances in technology and data collection,” according to the IOM report brief, titled "A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases."
“Chronic diseases, such as cardiovascular disease and chronic lung disease are common and costly, yet they also are among the most preventable health problems,” wrote the brief put forth by the IOM study committee appointed to develop frameworks for building a chronic disease surveillance system.
The committee said that such a system must have the capability to provide data on disparities of diseases by race, ethnicity, socioeconomic status and geographic region, along with data on disease risk factors and clinical care delivery.
During its research, the IOM committee outlined newer surveillance tools including EHRs, which can help to capture care events and processes. “Expanding the use of EHRs in surveillance will have challenges, including the relatively low numbers of hospitals and practices now using the technology,” the brief stated. “But use of EHRs is expected to expand as healthcare reforms advance, necessitating their inclusion when planning for a national surveillance system.”
In addition, IOM said that coupling patient health data with other larger health databases can help facilitate population surveillance. “Although these sources have yet to be fully assessed, the potential is great that some, if not all, of them may complement and extend chronic disease surveillance efforts, although privacy issues must be addressed.”
The IOM committee concluded that the Department of Health and Human Services (HHS) should take the lead in these efforts, as it is already positioned to provide funding and conduct surveillance efforts as well as bring together stakeholders from public and private sectors.
The institute said that the future system that should be developed by HHS to include:
- Incidence and prevalence of cardiovascular and chronic lung disease over time, which will enable tracking of progress in reaching established national health goals, such as those detailed in the government’s Healthy People reports;
- Primary prevention, including the reduction of behavioral, clinical and other risk factors associated with cardiovascular and chronic lung diseases and conditions; on secondary prevention, such as early detection and intervention; and on tertiary prevention to manage symptomatic disease;
- Health outcomes following surveillance, including changes in quality of life, and on costs, including direct medical costs and the indirect costs of lost productivity, earnings and social burden;
- Representative samples and data (e.g., at the substate or county level) to support local public health action to prevent and control chronic diseases; and
- Disparities in these factors by race or ethnicity, geographic region and socioeconomic status.
“A robust surveillance system will serve as a benchmark for clinicians treating patients with cardiovascular and chronic lung diseases. It will help in monitoring, evaluating, and improving policies, programs and services and in directing the placement of resources and it will provide a stronger basis for advocacy and education,” IOM noted.
The framework put forth by the IOM committee could serve as a building block for a national surveillance system to track chronic diseases.