Somebody's watching

5/11/2004

HIGH-TECH electronic surveillance programs involving medical practitioners are among the hottest weapons in the war on terrorism. Some wonder if they'll work or if they're worth the money.

Americans are used to being watched. Cameras are in so many places, nonchalance greets their intrusion. But new applications, some already in use, promise more personal looks.

The federal government now checks databases that include over-the-counter drug sales, as well as complaints that bring people to emergency rooms, and they're eyeing people's doctor and hospital records.

The stated, laudable aim of its surveillance, actual and contemplated, is to catch early signs of a bioterror attack.

Consider all the data the FBI and CIA gathered before 9/11, and how no one put it together. When operating budgets rest on the quicksand of politics, who will analyze this data long term, especially if early runs produce nothing of significance?

A huge added problem with the dream of a high-tech "public health information network" into which clinics, hospitals, doctors' offices, pharmacies, labs, public agencies, and responders feed facts about all Americans, is its erosion of privacy.

But keep in mind that not only is the task of assembling vast databases monumental, so are the costs.

BioSense, a program of the Centers for Disease Control and Prevention to look at OTC drug sales and hospital emergency room complaints, began working last year.

It joins BioWatch, a network of air sensors in 31 cities that sniff for toxic substances, and another CDC program to electronically track outbreaks of disease or other illnesses. If the proposed 2005 federal budget is passed as it is, which is hardly likely, $130 million will go to BioSense, and BioWatch funds will be doubled.

Illinois, ahead of many other states, has launched a $10 million electronic program to analyze health trends using ambulance dispatchers, ER complaints, and symptoms people reveal to doctors in office visits.

If something of note crops up, then what? Around the nation money-strapped public health agencies would likely be hard-pressed to respond. More promising in the high-tech medical field are hand-held devices in development for use to test for specific viruses or bacteria.

Whether they thwart bioterrorism, medical personnel see promise in their ability to identify diseases that kill more people than terrorism does. Tuberculosis, for example, is second to malaria as a killer worldwide.

It would be ironic if unintended uses proved the greatest benefit.