Professor Alan Zelicoff testifies to California Legislators on
Direct-Reporting Disease Surveillance Methods

In early 2006, Adjunct Professor Alan Zelicoff had the opportunity to brief California legislators on novel approaches to disease surveillance, arguing that clinician-based syndromic surveillance (CBSS) should be tested – in an open, controlled trial – to existing “data-mining” systems such as the CDC’s BIOSENSE system.  Given the marked success of the Syndrome Reporting Information System (SYRIS) in 44 counties in West Texas – with high physician and veterinarian compliance and high sensitivity and low false positve rate, Assemblywoman Shirley Horton (R-San Diego) decided to sponsor a bill bringing the same technology to California and introduced AB 1956 calling for a multi-year trial of CBSS systems in Feb. 2006. 

AB 1956 passed the Assembly unanimously in June of this year and the California senate by a vote of 33-1 in late August. No other bill calling for a new program in California passed both houses with such an overwhelming majority.  The bill is on Governor Schwarzenegger's desk for signature and all expectations are that he will sign it into law.  Multiple organizations testified in support of the bill: the California Medical Association (after a unanimous vote of its leadership), the California Association of Family Practitioners and Kaiser-Permanente. 

Interested readers can see the full text of the bill at: 

http://www.leginfo.ca.gov/pub/bill/asm/ab_19512000/ab_1956_bill_20060905_enrolled.html

The substantive advantages of this type of software are:

(A) Permits user-friendly, real-time reporting by clinicians of humans and animals and the rapid exchange of syndromic surveillance data among practitioners, including, but not limited to, physicians, nurses, and veterinarians.

(B) Provides for the validation and analysis of the data by the local health officer.

(C) Provides Geographic Information System (GIS) mapping of symptom occurrences by ZIP Code that is instantaneously accessible by local clinicians and the local health officer.

(D) Permits the local health officer to issue public health alerts to clinicians in his or her region.

(E) Ensures the confidentiality of medical recor information consistent with state and federal law.

Equally important is what the bill EXCLUDES: data-mining systems that do not involve direct reporting by clinicians.