Barriers to Timely Influenza Data and Specimen Submissions from Outpatient Influenza-like Illness Surveillance Network Providers, Kansas, 2012-2013 Influenza Season

BACKGROUND:   The U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) is a collaboration between the CDC and state, local, and territorial health departments. The Kansas Department of Health and Environment (KDHE) recruits health care providers throughout Kansas to participate in ILINet. Each week for 33 weeks during the surveillance period beginning September 30, 2012 and ending May 18, 2013, ILINet providers are asked to submit the total number of patients seen in their facility as well as the number of patients presenting with influenza-like illness (ILI). Data for the previous week should be submitted via internet or fax by 11:00 AM each Tuesday. On average, 18 of 43 providers submitted data by this deadline each week. ILINet providers were also asked to submit one clinical specimen per week to the Kansas Health and Environmental Laboratories (KHEL). Zero providers submitted a specimen for all 33 weeks, and only two submitted a specimen for more than 15 weeks.

METHODS:   An online survey of nine questions was distributed to ILINet providers who participated in the 2012-2013 season. Questions addressed barriers to timely submission of data and clinical specimens.

RESULTS:   Of the 42 ILINet providers during the 2012-2013 season, 27 completed the survey. Fourteen providers reported data submission required less than 15 minutes per week, ten providers reported 15-30 minutes, and three providers reported more than 30 minutes. Providers that required less than 15 minutes for submission averaged six more “on time” reports than those requiring longer than 15 minutes. The most significant factor inhibiting timely data submission was “other work responsibilities / lack of personnel.”  Specimen collection and shipping required 15-30 minutes per week for 15 providers, eight providers required less than 15 minutes, and three providers required more than 30 minutes. The most significant barrier for sending one specimen per week to KHEL was patients presenting greater than three days after onset of illness, outside of the required specimen collection timeframe.

CONCLUSIONS:   The primary barrier for timely data submission was competing work responsibilities, while patients presenting more than three days beyond symptom onset was the main barrier to specimen collection. Collecting one specimen per week per provider may be unrealistic, especially when patient volume is low. Eight of the 27 providers who completed the survey required less than 30 minutes per week for all surveillance activities. These results are helpful in ILINet recruitment, as expectations of time and effort can be shared with prospective providers.