In 1999 a pilot project was conducted in the Durham health region (population of 500 000) in Canada, to test the concept and a prototype of a rapid risk factor surveillance system. This project was initiated because some health regions (there are 136 health regions across Canada) felt the need to have a rapid and flexible information system to supplement the data from national health surveys. National health surveys cannot always be directed towards local needs, usually have a limited number of questions, have a delay in publishing results, and are rather infrequent.

The highly successful pilot project produced monthly data made available at the end of each month. It also permitted monthly changes in the questions and inclusion of questions not normally included in national health surveys. Based on the experience of the pilot project, we have the following vision of a rapid, flexible, cost effective, survey-based public health surveillance system.

Firstly, a franchise model. Health regions that subscribe to the system will provide funds for data collection in the respective health regions. Provincial and federal health agencies will contribute funds for central support and system development. Contractors will conduct telephone interview of 100 randomly selected people per month per health region. Thus if fully implemented, this will produce a national sample of 163 200 interviews per year in Canada.

Secondly, a turnkey package. Subscribers will get a comprehensive package that is completely ready for operation, from system design, data analysis, result interpretation to report writing. Health regions can “click and drag” to create their own questionnaire in any month from an inventory of standard questions, as governed by certain ground rules. Automated statistical packages will be provided for data analysis. Geographic information system (GIS) capabilities will be developed.

Thirdly, a global support system. To ensure that subscribers can use the system with comfort, there is help desk access to provide assistance, through a web site and a 24 hour toll free number. As in the OnStar system now available in some cars by which advisors can provide a car user with road maps and step by step global positioning, or send remote signals to unlock car doors when keys are locked inside, statistical advisors will provide guidance and help to users.

Routine national health surveys have not always been developed for the purpose of health surveillance. The feasibility of using ongoing sample surveys to supplement national health surveys needs to be further investigated.