Healthcare Provider Knowledge and Attitudes Regarding Reporting Diseases and Events to Public Health

BACKGROUND: In the United States (US), state laws require healthcare providers to report specific diseases to public health authorities, a fundamental facet of disease surveillance. Annually, the Tennessee Department of Health sends standard mail to all licensed providers in the state with updated reporting requirements and procedures. To report, providers are instructed to submit the Notifiable Disease Report Form (PH-1600) via standard mail or fax. However, reporting by healthcare providers is inconsistent, infrequent and delayed. Few recent studies have tried to understand barriers to provider reporting in the US. 

METHODS: We conducted a cross-sectional survey of healthcare providers in four specialties (internal medicine, pediatrics, obstetrics-gynecology and emergency medicine) at Vanderbilt University Medical Center (Nashville, TN), a large, tertiary academic medical center. A link to an anonymous, standardized electronic survey was sent via institutional email to all attending, house staff and mid-level care providers in the selected departments. The survey included thirty multiple-choice questions assessing knowledge of and attitudes regarding reporting diseases to public health authorities in Tennessee.

RESULTS: Of 1,648 invited participants, 437 (26.5%) responses were received. The majority of providers believed they cared for patients with reportable diseases (n=362/435, 83.2%) and felt that it was their responsibility to contact public health about these conditions (n=429/436, 98.4%). However, less than half had ever reported to public health (n=206/436, 47.3%), citing lack of knowledge of which diseases are reportable (186/429, 43.4%) and burdensome logistics of submitting a report (153/429, 35.7%) as the primary barriers. Most preferred secure email or web-based forms to report cases of disease (n=341/409, 83.4%). Less than half of licensed healthcare providers (n=74/206, 35.9%) reported that they had received communication from the department of health regarding updates to reporting requirements.

CONCLUSIONS: In this survey of over 400 healthcare providers at a large, tertiary medical center, most feel they care for patients with reportable diseases and believe they have an obligation to report to public health authorities. However, many healthcare providers describe a lack of knowledge about reporting procedures that may limit their ability to report effectively. Additionally, most providers report that they have not received a reportable diseases update from the department of health. These results suggest that enhanced communication methods between public health and providers, improved provider education on reporting procedures and the availability of electronic reporting may improve provider reporting rates in Tennessee.