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BACKGROUND: There is little information available on the costs to develop and maintain components of a biosurveillance system. To provide planners and funders of surveillance with an example of the involved costs, we performed a case study to estimate costs of developing and maintaining four components of biosurveillance, as part of research conducted by the North Carolina Preparedness and Emergency Response Research Center at the University of North Carolina, Chapel Hill.
METHODS: Staffing and cost estimates to develop four surveillance components—electronic laboratory reporting, communicable disease reporting, emergency department syndromic surveillance, and public health laboratory reporting—were collected from the New York State Department of Health (NYSDOH). These systems were built between 2000 and 2005 within the existing NYSDOH information technology environment and evolved over several years. Estimates are only approximate and may not reflect today’s costs.
RESULTS: The first three components were developed during the same five-year period with shared staff. Development cost was approximately $6.8 million, of which $200,000 was spent on hardware/software and the remaining $6.6 million on 11 staff. Staff to maintain and enhance the electronic laboratory reporting system and the syndromic surveillance system has required 2 state-funded contract developers ($350,000/year), 0.5 state-funded contract business analyst ($80,000/year), and 3 grant supported staff (2 developers and 1 business analyst, $500,000/year). Maintenance and enhancements to the reportable disease reporting system—mostly involving addition of disease specific modules—have required 2 state-funded contract programmers ($320,000/year), 1 state-funded contract project manager ($170,000/year), 0.5 state-funded contract business analyst ($80,000/year), 1.5 grant-funded programmers ($230,000/year), and 1 state-funded programmer ($100,000/year). Overall, the estimated cost to maintain and enhance all three systems has been well over $1 million per year. The cost to develop electronic laboratory reporting from New York’s existing public health laboratory information management system to the NYSDOH’s epidemiology office and all 57 counties required about 4 staff over a period of 2 years. Maintaining the system has required 2 full time staff for software modifications, vocabulary maintenance, new test messaging, training and help desk support, and troubleshooting.
CONCLUSIONS: Although the exact costs of this case study may not be generalizable to other states, these results show that the cost of developing new biosurveillance systems is considerable, even when an information infrastructure already exists. Such systems also require continuing maintenance and updating, adding long-term financial commitment.