New director, new wrinkle

Ever evolving, BioSense is adding yet another
wrinkle under its new administrator, Dr. Les
Lenert, director of the National Center for Public
Health Informatics at the Centers for Disease
Control and Prevention.

BioSense started in 2003 as an early-warning
system for detecting clusters of symptoms such
as high fevers or severe respiratory
distress that could
signal a flu pandemic or
emerging new disease. Daily
and even hourly data flows
into BioSense from hundreds
of hospitals, emergency
rooms and other health care sites.

The newest mission is to align BioSense more
closely with traditional public health reporting on
diagnosed infectious diseases, Lenert said.

"Our experience shows that knowledge of a
general syndrome is not as specific as what we
need," he said. "It is not just to detect suspicions
[of a disease] but to give situational awareness
over time."

Within five years, Lenert said, he hopes to
have BioSense's reports and analyses from
1,500 hospitals, 30,000 pharmacies and two
national laboratories aligned with traditional public
health reporting systems in all 50 states.
Some of this is already happening: For example,
during the recent California wildfires, BioSense
tracked visits to local hospitals for breathing difficulties
in addition to diagnosed conditions such
as asthma.

This year, BioSense is expected to work on
developing a federated database system that
would allow states to retain ownership of their
public health data but share it with CDC, Lenert
said. Currently, data from state public health systems,
hospitals and other sites flows into a central
BioSense database. Funding for BioSense in
fiscal 2008 is $34 million.

"The future of BioSense is one in which we will
link with states, but we do not move the data,"
Lenert said. Some state public health authorities
have been uncomfortable allowing health data to
flow directly to CDC because they are fearful of
being bypassed.

CDC is likely to consider contracts for development
of the database and services to keep the
current BioSense system running. Details were
not immediately available on when the new contracts
would be awarded or what their values
would be.

Meanwhile, the current BioSense contract,
held by Science Applications International Corp.,
expires in July but will continue under a no-cost
extension until October, Lenert said.

The new request for proposals will not resemble
the draft copy issued last year, and the price
tag might be lower than the previous $100 million
estimate, Lenert said.