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The BRFSS offers an excellent opportunity to implement a system for tracking important exposure-related behaviors as part of the EPHTN. The relatively low marginal cost of adding nationally developed optional modules or state-added questions, the flexibility inherent in the sample design, and the well-developed infrastructure and procedures make the BRFSS an attractive option for exposure tracking.
RBAC determines enduser access to surveillance programs such as the NBS (infectious disease reporting), SPHERE (Secure Public Health Electronic Record of the Wisconsin Maternal and Child Health Program), WE-TRAC (Wisconsin Early Hearing Detection and Intervention Referral and Coordination System), and the EPHTN childhood cancer pilot.
Table 2 displays the environmental, population, and health outcome data systems that are under evaluation for inclusion and linkage in the EPHTN IDR.
An EPHTN program meeting the PHIN requirements is only possible by combining multiple funding sources that support public health information technology.
Wisconsin's EPHTN childhood cancer pilot PAM has established a PHIN-compatible framework to track the environmental causes of disease.
Although this detailed environmental monitoring activity is outside of the project scope largely because of funding, the EPHTN PAM is positioned to integrate these kinds of measures because it can accept laboratory result messaging.
Exposure data represent the largest data gap for EPHTN. Ideally, exposure data would be available at the individual level, but very few of these types exist.
EPHTN efforts focus on the use of existing (secondary) data rather than on the generation of new data (primary).
The EPHTN is developing a framework to assess the impact of environmental agents on human health that will begin to fill in the "environmental health gap" described in the Pew Environmental Health Commission (2000) report.
Data sharing is essential to EPHTN and requires overcoming the organizational and functional problems limiting collaboration between health and environmental agencies.
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