When the COVID-19 pandemic hit Dallas County, Texas, paper-based disease reporting software was woefully unprepared.
“We were literally dealing with reams of paper, faxes, lab reports. We had medical students manually enter data,” said Dr. Philip Huang, county Health and Human Services Director. “We needed timely, accurate data, and we knew that trillions of dollars worth of policy decisions were being made across the country based on the number of coronavirus cases and whether they were increasing. I would like to point this out.”
The department decided in fall 2020 to upgrade its public health disease surveillance and surveillance system, a “gold record” that collects data from health care facilities, state agencies and county offices, Huang said. He said the upgrades have saved department staff from 15 hours of manual data entry each day and expanded the number of health conditions tracked to 120, but the department is primarily focused on COVID-19 infections, mpox, which is being used to track whooping cough.
It also helped track and treat last year's outbreak of mpox (a virus formerly known as monkeypox), but Huang told StateScoop that “it could have been much worse.” Ta.
number jump
In addition to the huge amount of effort required and the problems posed by manual data entry, previous systems did not work well with data feeds from other sources, Huang said. The state's system was the main source of vaccination data and was critical for targeted outreach efforts, he said.
“Because we were getting some of these data feeds from the state, and the state's system was backed up. And all of a sudden, a mass of 1,000 new cases that was being shut down in the state's system. We have received the data, we need to process it and we need to report these numbers,” Huang said. “Now, all of a sudden, in a day or two or three, the numbers jumped by another 1,000 people. Here, people didn't know what to make of it.”
He said the department worked with Accenture to implement a new system that runs on Salesforce, allowing the Dallas County Health Department to automate the ingestion of electronic records from the state. Fan said many hospitals in the Dallas area also began using electronic records to share case numbers in the aftermath of COVID-19.
The new system also enabled the rapid ramp-up of hundreds of contact tracers. Huang said the system's customer relationship management system addresses the needs of contact tracers to send text messages to people who test positive and seamlessly conduct contact tracing interviews.
It also allows health officials to track which census tracts contain the most unvaccinated people, which makes it easier for counties to target vaccination programs, he said. These efforts include block walking activities, pop-up clinics, vaccination events, and more.
ahead of the curve
Phan said all of this came in handy during last year's MPOX outbreak, when many local health authorities were struggling to respond as the COVID-19 pandemic dragged on. But that wasn't the case in Dallas County, Huang said. The new system identified high-priority residents and the county provided them with mpox education and prevention.
“So if you look at the epidemic curve of mpox, it's certainly not guaranteed that it's going to be that way. And this is a real success story in public health that people probably aren't paying much attention to. , it really could have been a lot worse,” Huang said.
Huang said he hopes the system will help track not only infectious diseases but also chronic diseases. And while the system can already accurately track information on 120 health conditions, Huang told StateScoop he wants to add more information and integrate information on other vulnerable groups, such as the homeless population. Ta.
“We're trying to get homeless information data into the system. So if we can find someone who has TB and recognize that they're in the homeless system, we can prevent further spread in those settings. We may be able to help treat them, isolate them, and isolate them to prevent this,” Huang said.
The Dallas County Health and Human Services Department was recognized Monday as a 2023 Health Information Management Systems Association Public Health Davis Award recipient for its modernization efforts.
