Table of Contents
Influenza Research and Treatment
Volume 2013, Article ID 242970, 10 pages
Research Article

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

1Department of Family and Preventive Medicine, University of Utah, 375 Chipeta Way, Suite A, Salt Lake City, UT 84108, USA
2Department of Biomedical Informatics, University of Utah, 26 S 2000 E RM 5700, Salt Lake City, UT 84112, USA

Received 31 January 2013; Accepted 19 March 2013

Academic Editor: Zichria Zakay-Rones

Copyright © 2013 Lisa H. Gren et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. Disease surveillance combines data collection and analysis with dissemination of findings to decision makers. The timeliness of these activities affects the ability to implement preventive measures. Influenza surveillance has traditionally been hampered by delays in both data collection and dissemination. Methods. We used statistical process control (SPC) to evaluate the daily percentage of outpatient visits with a positive point-of-care (POC) influenza test in the University of Utah Primary Care Research Network. Results. Retrospectively, POC testing generated an alert in each of 4 seasons (2004–2008, median 16 days before epidemic onset), suggesting that email notification of clinicians would be 9 days earlier than surveillance alerts posted to the Utah Department of Health website. In the 2008-09 season, the algorithm generated a real-time alert 19 days before epidemic onset. Clinicians in 4 intervention clinics received email notification of the alert within 4 days. Compared with clinicians in 6 control clinics, intervention clinicians were 40% more likely to perform rapid testing ( ) and twice as likely to vaccinate for seasonal influenza ( ) after notification. Conclusions. Email notification of SPC-generated alerts provided significantly earlier notification of the epidemic onset than traditional surveillance. Clinician preventive behavior was not significantly different in intervention clinics.