Page 24 - Timeliness of Infectious Disease Notification & Response Systems - Corien Swaan

22 Chapter 1
1.3 Timeliness of notification and response systems
Legal and operational aspects of timely disease notification and report- ing in the Netherlands
A timeframe is a period (days, weeks, months) in which an activity is required to happen. Many countries have a legal timeframe determining timeliness for notifications by physicians (D3P) and/or laboratories (D3X) and/or reporting timeliness for regional reporting (D4) and/or reporting on national level (D5). Timeliness timeframes differ between countries and/or states (37). In the Neth- erlands, five ‘group A’ diseases are notifiable upon suspicion by physician and laboratory, and 43 diseases, so-called ‘group B and C diseases’, are notifiable af- ter the patients disease is confirmed by laboratory testing (38). The law involving infectious disease notification changed in December 2008. Under the former so- called Law on Infectious Diseases, valid between April 1999 and December 2008, diseases categorized as ‘group B’ were notifiable for diagnosing physicians, while diseases categorized as ‘group C’ for (heads of) diagnosing laboratories (39). Physicians were required to notify diseases within one working day to the MHS.
In order to facilitate timely notification, and to increase reporting rates, laboratories were encouraged to agree on covenants with treating physicians, authorizing laboratories to notify both group B and C diseases, to the MHS (40, 41). Rietveld et al. confirmed that laboratories notify faster compared to physicians, in their region in the South of the Netherlands, as was shown by others as well (42, 43). Nowadays, the new Law on Public Health, valid from December 2008 on, requires both group B and C diseases to be notified by phy- sicians and laboratories to the MHS within one working day after laboratory confirmation (44). Based on a previous agreement between MHS and RIVM, notifications needed to be reported to the RIVM within 1, 3, or 7 days, or one month, depending on the specific disease. With the new Law on Public Health, these delays were adjusted to 1, 3, or 7 days only, depending on disease (45).
Regarding notification systems, MHS increasingly receive notifications electronically, through secured e-mail or web-based systems. In June 2003, the RIVM installed an electronic reporting system called ‘Osiris’, through which MHS report all cases to the RIVM. This system was shown to be faster and provide more complete reports than the previous postal mail system (8)
Performance indicators for evaluation of timeliness
Timeliness of data reporting is one of nine attributes of a public health surveil- lance system and defined as a requirement on the speed between steps in a