Gaps exist in the ability for local and state public health to capture the impact of the current H1N1 pandemic on in-patient hospital census statewide. In an effort to gather this important data without increasing the burden on hospitals, five questions specific to Influenza-Like Illness (ILI) were developed, vetted with hospital partners, and integrated into the current electronic data collection system in all Michigan hospitals. These five questions include: 1) Number of patients admitted with ILI; 2) Number of patients with ILI in an adult ICU; 3) Number of patients with ILI in a pediatric ICU; 4) Number of ILI related deaths; and 5) Total number of admissions (denominator data).
All of these data elements are captured for a 24-hour time frame prior to the activation of the event. Michigan utilizes an electronic data system that hospitals are familiar with, as it was originally developed to meet the baseline HAvBED reporting requirements consistent with the ASPR Hospital Preparedness Program. As such, this ILI event is activated in conjunction with the required DHHS HAvBED report due to the Secretary's Operation Center each week. This leverages the activities already underway in each hospital and provides public health a snapshot of in-patient hospital activity, an important piece of overall influenza surveillance. All hospitals understand that a need for increased reporting is possible based on the status of influenza activity.
Although collecting this information is more complex than routine bed categories, diversion status, and ventilator and decontamination availability through the traditional HAvBED alerts, MI has consistently had over 90 percent of the hospitals completing all reports. This, along with other surveillance data, has accurately indicated the current stress on in-patient activities in Michigan.
Once this data has been collected, working with the Bureau of Epidemiology, a report is generated to bench-mark the current week's data to that of the previous week for each of the eight emergency preparedness regions. This information is widely distributed to all hospitals and local public health and placed on the Michigan Health Alert Network to ensure that data submission and analysis is a two-way partnership between public health and healthcare. These five questions, combined with traditional public health surveillance including Emergency Department Syndromic Surveillance, Sentinel Physician, and School- and laboratory-based reporting in the Michigan Disease Surveillance System, provide solid information to assist in response activities.
