Disease Surveillance is an important tool today with the advent of new and fast spreading diseases. In some healthcare systems, it is used not only to check the spread of the infectious diseases but also to monitor communicable diseases. India has had a disease surveillance system in place since 2004 and systematically the disease data at the district level has been collected for states and collated at state and then national level to five us an idea of disease patterns in the region.
We caught up with Bipin Kumar,who is the assistant professor of Health Informatics in Mahatma Gandhi University of medical sciences and technology, Jaipur. His specializations are public health informatics, e- health, data science in healthcare. He is also serving as an editorial board member of journal of Indian association of Medical Informatics. Bipin has hands on experience on disease surveillance systems during his time as Health Officer at National Health Mission, Government of Gujrat. Below are some transcripts from the interview
Healthcare India: Why did the practice of disease surveillance start in the district?
Bipin Kumar: Disease surveillance is integral part of district health authority, where at district level there is centralized surveillance/ monitoring / compilation of the data done under district epidemiology officer. Due to the rise of the frequent episodes of communicable diseases which invariably leads to a public health threat, practice of disease surveillance at district level has become more important and routine for reporting purpose.
Healthcare India: So how did this practice start ?
Bipin Kumar: Integrated Disease Surveillance Program (IDSP) was launched with World Bank assistance in November 2004 to detect and respond to disease outbreaks quickly. World Bank funds were available for 9 identified states (Uttarakhand, Rajasthan, Punjab, Maharashtra, Gujarat, Tamil Nadu, Karnataka, Andhra Pradesh and West Bengal). Under this scheme disease surveillance practice improved with a decentralized laboratory based IT enabled disease surveillance system for epidemic prone diseases to monitor disease trends and to detect and respond to outbreaks
Healthcare India: Sounds very fascinating But what is the process of collecting information and tracking?
Bipin Kumar: The process starts with starts with medical officer at primary health center level with prescribed forms ( P and L forms ) here you can see notifiable diseases list under P form. Every disease prevalent in the region from Chikungunya to Kala Azar is listed and a description given. This helps the officer to identify and list the diseases. These all filled in forms are collected and entered in state IDSP portal on weekly basis. Similar other form is L form also being updated in same fashion.
Healthcare India: What are the key advantages of this system?
Bipin Kumar: The biggest advantage is that it is real time reporting, we know of an outbreak almost immediately. Secondly the system is transparent and there is validity as there is real on ground verification by the medical officer that there is a outbreak. Finally is it a system, so most disease patterns are systematically collected and analysed.
The beauty of the system is that there is integration and at the same time decentralization of surveillance activities through establishment of surveillance units at Center, State and District level. Technology is being used for for collection, collation, compilation, analysis and dissemination of data for action plan
Healthcare India: What were some of the key insights in your association with this program?
Bipin Kumar: There was a lot of learning and they can be listed as below
- Use of technology in collection , reporting and analysis in surveillance program
- Very systematic universal reporting system throughout India.
- Time bound data entry facilitates real time analytics and actionable insight
- Has dedicated team for IDSP at central state and district level
Healthcare India: Were there any key insights on disease patterns for your district?
Bipin Kumar: Highly variable in our district but we have significant number of cases with public health threat , swine flu , dengue and chikungunya in recent past. Measles, which was emerging in our district also got reported through this system had systematic rapid response from the healthcare teams for treatment.
Healthcare India: What are advantages of the disease surveillance to the government? Hospitals? and to Physicians?
Bipin Kumar: I think the system can be used by all parts of the healthcare ecosystem
Physician : Will get real time feedback from health workers for notifiable diseases. They will become system aware about reporting system for communicable diseases. And this would form a good feedback mechanism between the physicians and case workers
Hospitals : They have legal duty to notify communicable diseases, digital enable reporting system and it helps the hospitals to prepare for the outbreaks. They can stock up on medicines and assign duties to medical and paramedical staff based on this data.
Government : Information enabled decision making and policy decision for resource allocation for public health systems. Finally this data helps in research and planning.
Thank you Bipin for taking time out from your schedule and working with us on this. I am sure there is tremendous interest in disease surveillance and this would continue to grow as we continue to leverage technology to build the care system of the future.
Please send us your comments and suggestions on Disease Surveillance or any other topic of interest that you might have.