Use of a clinical decision support system to diagnose bioterrorism or epidemic events

Computer based surveillance systems most frequently monitor hospital, laboratory and pharmaceutical data for early warning signs of terrorism or epidemics, yet surveillance alone has limitations. Patients may not be diagnosed in close temporal relation, eluding surveillance systems. Also, given the acuity and virulence of many bioterror agents, early detection is imperative. A single patient may indicate the beginnings of a mass event and appropriate diagnosis is necessary to contain an outbreak. Rare, complex and unusual clinical presentations are inherent when considering the diagnosis of chemical, biologic or an uncommon emerging infectious disease. Traditional CME methods around bioterrorism such as didactic lectures or online tutorials may not be totally effective in preparing clinicians to identify these rare diseases due to problems with recall. Assisting clinicians by providing point of care diagnostic tools is a new public health strategy to support early diagnosis and recognition of these events. This presentation will demonstrate a clinical decision support system (CDSS) known as VisualDx to enhance early clinical diagnosis and to close the gap on reporting and surveillance of diseases of importance; the CDSS has been deployed into more than 400 emergency departments by more than 20 health departments in the U.S. The CDSS is dual-use, meaning it can be used to diagnose common diseases such as pneumonia and STDs, skin rashes and drug reactions in addition to rare bioterrorism related diseases. The CDSS also has a reporting functionality to insert local alerts and reporting links. As such, clinicians can use the tool daily and are familiar with the search functionality if they suspect bioterrorism, and are reminded to report when applicable. With diagnostic support at the point of care, an outbreak can be quickly identified and contained and clinicians do not have to rely upon recall of past CME activities.