SmiNet-2: Description of an internet-based surveillance system for communicable diseases in Sweden

Electronic systems for communicable diseases surveillance enhance quality by simplifying reporting, improving completeness, and increasing timeliness. In this article we outline the ideas and technologies behind SmiNet-2, a new comprehensive regional/national system for communicable disease surveillance in Sweden. The system allows for reporting from physicians (web form) and laboratories (direct from lab data system) over the internet. Using a unique personal identification number, SmiNet-2 automatically merges clinical and laboratory notifications to case records. Privileged users, at national and county level, work against a common central server containing all notifications and case records. In addition, SmiNet-2 has separate county servers with tools for outbreak investigations, contact tracing and case management. SmiNet-2 was first used in September 2004. Individual counties receive up to 90% of all notifications electronically. In its first year, SmiNet-2 received 54 980 clinical notifications and 32,765 laboratory notifications, which generated 58,891 case records. Since most clinicians in Sweden have easy access to the internet, a general web-based reporting has been feasible, and it is anticipated that within a few years all reporting to SmiNet-2 will be over the internet. In this context, some of the major advantages of SmiNet-2 when compared with other systems are timeliness in the dataflow (up to national level), the full integration of clinical and laboratory notifications, and the capability to handle more than 50 diseases with tailor-made notification forms within one single system.