Learning to design new systems: communicable disease surveillance.

The basis for public health actions and its supporting information systems are being questioned. Problems with the New Jersey communicable disease surveillance system were examined. Inability to discriminate unusual disease patterns was disclosed. In addition, there was prolonged processing time, high costs, and lack of capability to identify emerging infections. A new approach for communicable disease surveillance using a hospital laboratory isolate-based reports is described. The project could have been completed faster and with less expense if the project could have benefited from other recent management experience dealing with similar problems.