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Rhode Island says centralized bite reporting, REDCap and health‑department review cut unnecessary PEP; $68M estimated saved over 10 years
Summary
Rhode Island Department of Health described a centralized animal‑bite reporting and PEP authorization system built on REDCap that reduced PEP recommendations and, using conservative assumptions, produced an estimated $68 million in health‑care savings from 2013–2022.
Rhode Island public‑health officials described a centralized rabies control program that routes animal‑bite reports into a single REDCap system, enables nurse review and partner coordination, and has reduced unnecessary PEP releases while improving documentation of vaccine schedules.
Alexia Goodman, public‑health epidemiologist at the Rhode Island Department of Health, explained that the state moved its animal‑bite reporting system into REDCap in January 2025; the platform requires core data at intake and lets RIDOH manage investigation, risk assessment and PEP authorization in one place. Goodman said internal evaluation estimated that REDCap saved the animal‑bite team six to seven months of work by eliminating duplicate tasks.
Dr. Katie Donovan, deputy state epidemiologist at the Rhode Island Department of Health, presented program evaluation data for 2013–2022. She said approximately 30,000 animal‑bite exposures were reported to the state in that period; PEP was authorized for 25% (~7,500) of reported cases, leaving roughly 22,500 people who did not receive PEP. Using Brown University Health billing data for average PEP charges and conservative assumptions drawn from prior studies (she used a 25% counterfactual rate for inappropriate PEP), RIDOH estimated about $68 million in healthcare savings over ten years and at least $8 million saved in 2022 alone.
Donovan emphasized that program savings appear driven by increased animal testing and monitoring, improved counseling and in‑depth risk assessment by public‑health nurses. She concluded: “Provider consultation with the local health department” is the most important factor in ensuring appropriate PEP use.
Program implications: Rhode Island’s centralized workflow allowed public health to authorize vaccine release, share precise schedules with treating facilities and monitor schedule adherence and deviations. Officials said that where feasible, states should consider centralizing bite reporting and resourcing labs and quarantine processes to reduce unnecessary PEP and the associated patient and system burdens.
