The Value of Confidential Morbidity Reporting

It is certainly true that the CMR reporting system allows us to follow county disease trends and geographical distributions. In addition, there are other and probably more frequent if somewhat less dramatic benefits. The CMR system contrib-utes in a small way to the state’s ability to determine statewide trends and statistical occurrences as well as helping the state determine allocations of funding for various programs.

However, on a local level, it also enables the health department to determine its program needs. Generating local data is also much more likely to stimulate interest locally in public health issues compared to a system in which we only share state data. It also plays an important role in maintaining local vigilance — which, in turn, promotes public confidence that the local health department is actively safeguarding the community rather than only reflexively doing what the state determines we need to do.

We are often able to respond to public requests for health information, which is useful in reducing anxiety about unfounded beliefs and perceptions — in other words, imagined as opposed to real trends or threats of disease.

By providing local information to individual physicians and emergency rooms, we can help increase the index of suspicion of disease and remind our local practitioners that certain diseases are, in fact, present in our community. Local information also helps the public and private sectors to discern patterns in cases whose connections are not immediately obvious.

In doing all of the above, we also attempt to determine the degree or prevalence of disease reporting so that we do not underestimate or overestimate the incidence or prevalence of disease. We can avoid either a false sense of security or an unnecessary sense of danger.

Finally, we also can use the information to justify, locally, requests for additional infrastructure (real money) as well as to justify grant applications and other funding streams.

CMR reporting does contribute to general safety when used by the Department of Motor Vehicles to remove vehicle operators who present a danger because of medical conditions.

Potential uses for the CMR reporting system include, as we incorporate modern technology and scientific theory, determining more exact geographical distribution of disease with global positioning techniques. Of course, this is only a modern improvement of the older stick-pin-on-the-wall map technique.

We will potentially be able to use CMR reporting at the county level to elicit risk factors, help determine areas needing intervention as well as evaluating the effectiveness of those interventions.

In more subtle situations, it will help us distinguish between effective interventions and those that appear to be effective but, when compared to statewide results, are due to changing trends. In the future, the reporting system may also help us better justify requests for infrastructure, grants and other funding streams to enable us to perform more community service.

A reliable CMR reporting system with full participation of the community’s care providers will allow the Public Health Department to develop an accurate global picture of the community’s heath. That is our goal.

sdrogin@co.el-dorado.ca.us