August 17, 2006
Billing data routinely collected by primary care providers can help public health authorities detect outbreaks of emerging infections, according to a pilot study conducted by UNC researchers.

The study, published in the July/August 2006 issue of the Annals of Family Medicine, tracked standardized illness codes recorded each day at a primary care practice in Eden, N.C., during a one-year period. Generating the daily illness code summary took 1 to 2 minutes, using software that was created for the study at a cost of $1,500.

The researchers compared the primary care practice data to similar data collected during the same period at UNC Hospitals’ Emergency Department. The team found spikes of activity during the year, with increases occurred first in the primary care practice. This suggests that the practice may have seen patients with influenza earlier than the emergency department. The researchers conclude that it is feasible to implement surveillance in primary care practices at low cost and with minimal staff effort.

Lead author of the study is Dr. Philip D. Sloane, Elizabeth Shreve and Oscar Sexton Goodwin distinguished professor and associate chair in the department of family medicine and co-director of the program on aging, disability, and long-term care at UNC’s Cecil G. Sheps Center for Health Services Research.

Co-authors were Jennifer K. MacFarquhar; a nurse in the Statewide Program for Infection Control and Epidemiology at UNC; Emily Sickbert-Bennett, a public health epidemiologist for the University of North Carolina Health Care System; C. Madeline Mitchell, research associate at the Sheps Center; Roger Akers, research associate and deputy director of data at the Sheps Center; Dr. David J. Weber, a professor in the UNC schools of medicine and public health and medical director of hospital epidemiology at UNC Hospitals; and Dr. Kevin Howard of Dayspring Family Medicine in Eden, N.C.

The study was supported by a grant from the U.S. Agency for Healthcare Research and Quality.


UNC School of Public Health contact: Ramona DuBose, 919-966-7467,

UNC School of Medicine contact: Thomas Hughes, 919-966-6047,

News Services contact: Becky Oskin, 919-962-8596,



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