The recent bioterrorism scare has served as a wake-up call to our public health system, exposing its inability to track epidemics?from run-of-the-mill influenza to top threats such as smallpox. But even before last year\u2019s anthrax cases, doctors and public health officials had been testing Web-based databases and other bio-surveillance technologies that could help monitor medical data to stem an outbreak before it spreads.At Children\u2019s Hospital in Boston, a team of researchers is testing a network that offers real-time surveillance of hospital data, a website that lets clinicians report events or trends suggestive of bioterrorist activity, and decision-support systems to provide appropriate responses to outbreaks. "The benefit of the surveillance network is early detection so we can treat or isolate the problem," explains Dr. Kenneth Mandl, attending physician in pediatric emergency medicine at Children\u2019s Hospital and assistant professor of pediatrics at Harvard Medical School. "And the decision-support network will help frontline docs treating victims of diseases that they have never seen before." It will be at least two years before researchers really understand what the output from the pilot system means and how to respond, Mandl says.Meanwhile, the U.S. Air Force completed phase one of a $13.3 million project that created an infectious disease detection database and e-mail alert system. "We\u2019re interested in protecting against the use of biologic weapons by terrorists," says Col. Robert Munson, U.S. Air Force division chief of science and technology and assistant surgeon general for expeditionary operations, science and technology. But the system lends itself to more day-to-day uses, he adds, such as stemming hospital-acquired infections.Some worry that new patient privacy laws under HIPAA could get in the way of information-sharing needed to identify incipient epidemics. Those involved in these efforts say that maintaining security by transmitting and displaying only aggregate data is critical, adding that there may be exceptions to HIPAA when it comes to public health.