Bridging the Gap Between Public and Private Healthcare

Abstract

This article describes the development, testing, and implementation of the OKAlert-ILI System, a bidirectional, dual-use influenza-like illness surveillance and messaging system, during the influenza seasons of 2003-2004 and 2004-2005 in the Oklahoma Physicians Resource/Research Network, a primary care practice-based research network. We describe how the Oklahoma Physicians Resource/Research Network connected 30 primary care providers to the Oklahoma State Department of Health and how surveillance results were analyzed and fed back to the clinicians on a weekly basis. We demonstrate the timeliness, sensitivity, specificity, acceptability, validity, flexibility, and cost of the system. Finally, we describe upgrades and enhancements to the system based on user evaluation and feedback.

Point-of-Care Testing as an Influenza Surveillance Tool: Methodology and Lessons Learned from Implementation

“…Studies have reported that clinician perception of the care they provide, as well as actual diagnosis and use of resources, is improved when surveillance data are available to them [18, 19, 28, 34, 36–38]. However, we did not find significant differences between intervention and control clinics with regard to the clinician behaviors we measured.…”

“…We minimized the possibility of a false positive early signal by defining our real-time surveillance alert as a peak that contained a point exceeding the upper control limit followed by a point that did not return to the center line rather than using a single point for the alert. Based on this conservative definition, the timeliness of our early alert was similar to that seen in other studies [26–28]. However, further study using a confirmatory test such as viral culture or polymerase chain reaction would be required to determine whether these earlier peaks in our population are false positives or represent the earliest circulation of influenza in the population.…”

“…Three studies have used alternative modeling techniques with ILI data and demonstrated earlier signals relative to traditional ILI surveillance [26–28]. A fourth study reported that the proportion of clinical visits with a positive rapid influenza test result began rising 2–5 weeks earlier than the proportion of ILI [9].…”

Valuable Lessons for Pharmacist PBRNs: Insights and Experiences from Physician PBRN Members

“…Approximately 280 clinicians in 170 practices throughout the state of Oklahoma comprise the OKPRN. Network members have participated in research on a broad array of topics, such as patient–physician email communication [31], patient social support and advocacy [32,33], health information technology and exchanges [34,35,36,37,38], preventive/screening services [39,40,41], hypertension management [42,43], management of lab test results [44], and prescription refills [45].…”