A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases (2011) / Chapter Skim
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7 Using Surveillance Data for Action
7 Using Surveillance Data for Action
Pages 107-118
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From page 107... ...
The committee's rationale for a nationwide cardiovascular and chronic lung diseases surveillance system is based on the recognition of major gaps in current monitoring approaches and on new opportunities provided by emerging technologies, data collection mechanisms, and healthcare reform. Rather than construct an entirely new surveillance system, however, the committee concluded that existing surveillance data collection efforts and cohort studies can and should be strengthened and integrated to provide the necessary surveillance information.
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From page 108... ...
The committee believes strongly that federal agencies should collaborate with the many state and local public agencies and national and state-level, nongovernmental organizations that conduct components of the proposed system. The use of a coordinating body, as the committee recommends below, is in line with the approach taken by Canada in its developing Canadian Chronic Disease Surveillance System2 (CCDSS)
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From page 109... ...
A surveillance system for cardiovascular and chronic lung diseases must provide data that can be used to understand the continuum of pre vention, disease progression, treatment, and outcomes, and can be flexible enough to respond to new challenges and opportunities. Data are needed that can provide information on • Incidence and prevalence of relevant conditions over time; • Primary prevention, including both elimination of exposures in the physical and social environments that cause these diseases and reducing behavioral, clinical, and other risk factors (e.g., physical inactivity, poor diets, and smoking)
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From page 110... ...
The trajectory of a chronic disease usually begins at younger ages with a period of apparent good health, often with underlying risk factors present. Some risk factors may be genetic or congenital, others may be behavioral, and others may be found in the person's social or physical environment.
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From page 111... ...
Recommendation 3 The committee recommends that HHS adopt the framework illustrated in Figure 7-1 as a guide for national surveillance of cardiovascular and chronic lung diseases. The framework organizes data from traditional, evolving, and novel surveillance sources to reflect the devel opment and progression of chronic conditions over a life course.
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From page 112... ...
The increase in value of the multiple federal data sets that collect information from subjects, patients, health care providers, and healthcare insurers would be increased substantially if linkages across data sources were possible. The use of multiple informants to measure the burden of cardiovascular and chronic lung disease risk factors, behaviors, treatments, and outcomes could provide a comprehensive active surveillance system capable of providing information that could be used by multiple stakeholders to analyze, understand, and act effectively.
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From page 113... ...
; • Formation of public–private partnerships with the nongovernmental health sector; and • Development of data sets for surveillance sources that can be made broadly accessible to a variety of users to support and guide action to improve health at the national, state, and local levels. While the working group will provide direction as outlined above, a mechanism must be established to facilitate implementation of the enhanced and integrated system as it evolves.
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From page 114... ...
Arguments in favor of designating NCHS as the office to coordinate the surveillance system include its portfolios of national surveys, which provide key national information on prevalence and distribution of disease and associated risk factors. NCHS also collects data on many chronic diseases and vital statistics, so it would be in a good position if the system were to expand to include chronic diseases in general.
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From page 115... ...
While data from national surveys conducted by the federal, state, or local governments are usually readily avail able, private sources of data are frequently inaccessible or accessible only with great difficulty. A greater national investment is needed to ensure that chronic disease surveillance data are accessible to potential data users with a wide range of technical capacities.
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From page 116... ...
Recommendation 9 The committee recommends that the Office of the National Coordinator for Health Information Technology expand the minimum data for electronic health records to include behavioral, social, and environ mental risk factors for cardiovascular and chronic lung diseases in validated, interoperable ways in order to enhance the quality of surveillance data for these conditions. Because EHRs are currently in use in only a minority of hospitals and practices, several interim steps are needed before their potential can be realized.
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From page 117... ...
2001. Updated guidelines for evaluat ing public health surveillance systems: Recommendations from the guidelines working group.
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