By Matt Leingang
The Cincinnati Enquirer

Billie Stevens (front), health-unit coordinator, works in the Emergency Department at University Hospital this week. University is one of 14 hospitals that will link to a computer system that could detect an early bioterrorism attack. The Cincinnati Enquirer/GARY LANDERS

Fourteen hospitals in Greater Cincinnati soon will link to a computer system that tracks the symptoms of every patient who comes into their emergency rooms, searching for similarities that might signal a bioterrorist attack.

This early-warning system, the same technology installed in Utah before the 2002 Winter Olympics, is part of a national effort to respond as quickly as possible to episodes of biological or chemical poisoning.

Federal officials said last week they have information that al-Qaida is plotting a terrorist attack in the United States, possibly this summer.

Locally, plans to link to this alert network have been in development for the past eight months and are expected to be finalized in July. Area health departments are providing $11,000 for the connection.

Patients won't notice any difference.

Behind the scenes, however, certain information about them - age, gender, home ZIP code, work ZIP code and primary medical complaint - will be downloaded to a laboratory at the University of Pittsburgh, where computers will look for unusual surges in respiratory distress, gastrointestinal illness, skin rashes and other symptoms.

Those ailments can be the first signs of exposure to a biological or chemical agent. Within hours, the University of Pittsburgh could notify public health departments in Greater Cincinnati about any suspicious clusters in hospitals, neighborhoods or other parameters.

Although supporters of the effort, including top Bush administration officials, think that stepped-up surveillance is crucial to treating patients more effectively and containing outbreaks, critics say the concept is largely untested.

Supporters also are trying to dispel privacy concerns. Nobody's personal information - addresses, birth dates, Social Security numbers - will be shared with the system, they say. Under existing public health law, hospitals can release that identifying information to local health departments if an investigation is warranted.

"This technology is another tool that will allow us to see the big picture of the community's overall health," Hamilton County Health Commissioner Tim Ingram said.

The computer network will not replace the work of local epidemiologists - scientists at health departments who study diseases and detect outbreaks, Ingram said. They will have access to the same hospital data being sent to Pittsburgh and will continue to talk with physicians about the cases they see in their emergency rooms.

But speed is where the alert network might pay off. Symptoms are updated constantly, and the data - especially ZIP codes - can be sorted in ways that quickly pinpoint a possible attack.

About 100 other metropolitan areas - including New York, Boston and Washington, D.C. - have some kind of computerized hospital surveillance system, said Dr. Tracee Treadwell, chief epidemiologist with the bioterrorism preparedness and response program at the U.S. Centers for Disease Control and Prevention.

The University of Pittsburgh isn't the only place such technology has been developed. Boston, for example, developed its own citywide network. But public health officials in the Tristate opted to connect to an existing network.

Columbus is also linked to the Pittsburgh network. Using $330,000 in federal bioterror preparedness money, the state Health Department will help 70 hospitals in other parts of the state go online by August.

In Kentucky, hospitals in Louisville are using this system.

"The bottom line is that this is a great concept, but it remains to be seen how effective it is," said Michael Stoto, a senior statistical scientist with the military think tank Rand Corp., who has studied these surveillance networks.

"If there were a terrorist attack involving hundreds of people going to emergency rooms, you wouldn't need a sophisticated computer system telling you that something is going on," Stoto said.

And small attacks could be missed completely, Stoto said. For example, five people who unknowingly inhaled anthrax might not stand out from other emergency-room patients with respiratory problems.

Ingram acknowledged that the network is not perfect, but it has great potential.

Plus, the network could provide other benefits not related to bioterrorism, such as the early detection of influenza, West Nile virus and other seasonal ailments.

"The faster we can identify an outbreak, the faster we will be able to treat patients," said Carol King, vice president of emergency services at the Health Alliance, a health system that includes six hospitals in Cincinnati and Northern Kentucky. All six have agreed to participate in the surveillance program.

Ingram said the goal is to eventually get all 29 acute-care hospitals in Greater Cincinnati linked to the alert network.

E-mail mleingang@enquirer.com