(5) Surveillance: Surveillance is the ongoing systematic collection, analysis and interpretation of health outcome data for use in the planning, implementation and evaluation of public health practice. There are many purposes for surveillance including: to establish a registry for follow up and epidemiological investigations as well as to use as a resource for short-term disaster medical intervention. It is especially critical the first 48 hours as information gathered then is used to determine action and treatment. In addition, surveillance is needed to treat and track patients and to learn from the incident. (a) Patient care comes first, so hospital personnel should focus on decision-making data, especially for patient treatment. Records should be user-friendly to practitioners. (b) Key data for collection includes patient demographics, patient location at the time of the incident, and contact information for later follow-up. (b-1) Consider including the patient's description of what happened, details about the conditions at the location at the time of exposure, and the patient's chief complaints. (b-2) Record therapeutic data, including treatment, body location of radioactive contamination and isotope identification if known. (c) It would be valuable to gather data for an hour-by-hour summary of some basic information that includes a count of people affected by the immediate incident (the number could grow markedly over time) and key patient complaints. (d) Encourage staff to use current technology/electronic storage to implement and integrate surveillance information. (e) Radiation exposure may have long-term consequences; therefore, there is an additional long-term issue of registry tracking. Although this should not be an immediate concern of the hospital, the hospital can readily define the population up front for future tracking and epidemiological studies. (f) The Health Insurance Portability and Accountability Act (HIPPA) rules limit access to this information; therefore it is not clear now how this will play out in an incident involving mass casualties. Some states have flexibility for creating a list of reportable conditions to track and report. HIPAA allows (but does not require) health care providers to supply this information to appropriate authorities without patient authorization for law enforcement and public health activities (45 CFR164.512 (a) (1) and (2). Additionally, some states require reporting of suspected terrorism incidents. Hospitals should check with their state on these issues