scholarly journals Regional Governance of Syndromic Surveillance for the Texas Gulf Coast

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Wesley McNeely ◽  
Eunice R. Santos ◽  
Biru Yang ◽  
Kiley Allred ◽  
Raouf R. Arafat
Keyword(s):  
Public Health ◽  
Communities Of Practice ◽  
Syndromic Surveillance ◽  
Health Department ◽  
Regional Governance ◽  
Local Health ◽  
Health Departments ◽  
Care Providers ◽  
Local Health Departments ◽  
Syndromic Surveillance System

ObjectiveDescribe and explain the transition of the syndromic surveillanceprogram at the Houston Health Department (HHD) from being alocally managed and aging system to an ESSENCE system governedby a regional Consortium of public health agencies and stakeholdersin the 13-county area of the southeast Texas.IntroductionSyndromic surveillance systems are large and complex technologyprojects that increasingly require large investments of financial andpolitical capital to be sustainable. What was once a minor surveillancetool in the mid-2000s has evolved into a program that is regardedas valuable to public health yet is increasingly difficult to maintainand operate for local health departments. The Houston HealthDepartment installed a syndromic surveillance system (SyS) sixyears before Meaning Use became known to healthcare communities.The system chosen at the time was the Real-time Outbreak DiseaseSurveillance System (RODS) which, at the time and for its purpose,was a suitable platform for syndromic surveillance. During the past13 years however, maintaining, operating, and growing a SyS by alocal health department has become increasingly difficult. Inclusionin Meaningful Use elevated the importance and profile of syndromicsurveillance such that network growth, transparency of operations,ease of data sharing, and cooperation with other state systems inTexas became program imperatives.MethodsWith support from the informatics group at Tarrant County PublicHealth (TCPH) in the form of mentoring, HHD devised a two prongstrategy to re-invigorate the syndromic program. The first was toreplace RODS with ESSENCE from Johns Hopkins Applied PhysicsLaboratory (JH/APL). The second was to strengthen the regionalnetwork by creating a governance structure that included outsideagencies and stakeholders. The product of this second effort wasthe creation of the Syndromic Surveillance Consortium of SoutheastTexas (SSCSeT) on the Communities of Practice model1usingparliamentary procedure2.ResultsAcquiring ESSENCE and forming SSCSeT were necessary stepsfor the continuing operation of the SyS. The Consortium includesmembers from local health jurisdictions, health care providers, healthpolicy advocates, academicians, and data aggregators. Created asa democratic society, SSCSeT wrote its constitution and by-laws,voted in officers, formed working groups and has begun developingpolicies. The Consortium is cooperating with the Texas Departmentof State Health Services (DSHS) as well as TCPH. Having ESSENCEwill ensure the HHD-SyS will conform to standards being developedin the state and provide a robust syndromic platform for the partnersof the Consortium.ConclusionsSyndromic systems operated by local health departments canadapt to regulatory changes by growing their networks and engagingregional stakeholders using the Communities of Practice model.

scholarly journals Patterns and Correlates of Public Health Informatics Capacity Among Local Health Departments

2014 ◽  
Vol 6 (3) ◽  
Author(s):  
J. Mac McCullough ◽  
Kate Goodin
Keyword(s):  
Public Health ◽  
Information Exchange ◽  
Health Informatics ◽  
High Capacity ◽  
Local Health ◽  
Health Departments ◽  
Public Health Informatics ◽  
Local Health Departments ◽  
Syndromic Surveillance System ◽  
Service Portfolio

Objective: Little is known about the nationwide patterns in the use of public health informatics systems by local health departments (LHDs) and whether LHDs tend to possess informatics capacity across a broad range of information functionalities or for a narrower range. This study examined patterns and correlates of the presence of public health informatics functionalities within LHDs through the creation of a typology of LHD informatics capacities.Methods: Data was available for 459 LHDs from the 2013 National Association of County and City Health Officials Profile survey. An empirical typology was created through cluster analysis of six public health informatics functionalities: immunization registry, electronic disease registry, electronic lab reporting, electronic health records, health information exchange, electronic syndromic surveillance system. Three-categories of usage emerged (Low, Mid, High). LHD financial, workforce, organization, governance, and leadership characteristics, and types of services provided were explored across categories.Results: Low-informatics capacity LHDs had lower levels of use of each informatics functionalities than high-informatics capacity LHDs. Mid-informatics capacity LHDs had usage levels equivalent to high-capacity LHDs for the three most common functionalities and equivalent to low-capacity LHDs for the three least common functionalities. Informatics capacity was positively associated with service provision, especially for population-focused services.Conclusion: Informatics capacity is clustered within LHDs. Increasing LHD informatics capacity may require LHDs with low levels of informatics capacity to expand capacity across a range of functionalities, taking into account their narrower service portfolio. LHDs with mid-level informatics capacity may need specialized support in enhancing capacity for less common technologies.

scholarly journals Syndromic Surveillance – Reports of Successes from the Field

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Antheny Wilson ◽  
Teresa Hamby ◽  
Wei Hou ◽  
David J Swenson ◽  
Krystal Collier ◽  
...  
Keyword(s):  
Public Health ◽  
Data Quality ◽  
Syndromic Surveillance ◽  
Surveillance Program ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Success Stories ◽  
Department Of Health ◽  
State And Local

Objective: This panel will:● Discuss the importance of identifying and developing success stories● Highlight successes from state and local health departments to show how syndromic surveillance activities enhance situational awareness and address public health concerns● Encourage discussion on how to further efforts for developing and disseminating success storiesIntroduction: Syndromic surveillance uses near-real-time emergency department and other health care data for enhancing public health situational awareness and informing public health activities. In recent years, continued progress has been made in developing and strengthening syndromic surveillance activities. At the national level, syndromic surveillance activities are facilitated by the National Syndromic Surveillance Program (NSSP), a collaboration among state and local health departments, the CDC, other federal organizations, and other organizations that enabled collection of syndromic surveillance data in a timely manner, application of advanced data monitoring and analysis techniques, and sharing of best practices. This panel will highlight the importance of success stories. Examples of successes from state and local health departments will be presented and the audience will be encouraged to provide feedback.Description: ●Success stories – acknowledging and informing syndromic surveillance practiceThis presentation will discuss the importance of success stories for NSSP focused on increasing syndromic surveillance representativeness, improving data quality, and strengthening syndromic surveillance practices among grant recipients and partners. From the beginning of the program, the identification of success stories has been an important part of the efforts to develop knowledge base that better guide syndromic surveillance program activities.●NJ and BioSense – Making The Connection The New Jersey Department of Health (NJDOH) uses Health Monitoring’s EpiCenter as its primary ED data for syndromic surveillance. This data is also submitted to CDC’s NSSP BioSense Platform. In April 2017, a spike in ED Visits of Interest was identified by a CDC NSSP subject matter expert and brought to the attention of NJDOH’s data analyst. Data showed an increase in “Exposure” and “School Exposure” chief complaints in two contiguous counties. News reports showed the visits resulted from a dormitory fire at a university in the area. The NSSP and NJDOH staff collaboration integrated data from both NJDOH’s EpiCenter and CDC’s BioSense Platform for further investigation. This activity shows BioSense Platform’s potential as an additional syndromic surveillance tool because of its different classifications and keyword groupings.●Evaluation and Performance Measures at the Utah Department of HealthSyndromic surveillance related evaluation activities at the Utah Department of Health requires collaboration between subject matter experts and system users from the UT-NSSP workgroup. The progress is examined quarterly and outcomes compared with the short-, mid-, and long-term outcomes listed in the NSSP logic model to ensure activities are in sync with the program’s overall goals. Throughout the budget year, a variety of tools were used to keep track of the progress. During this session, challenges and successes, lessons learned, and effective strategies will be discussed.●NSSP R tool Data Download Useful in NHThe New Hampshire Department of Health and Human Services (NH DHHS) uses the state-wide Automated Hospital Emergency Department Data (AHEDD) system as its primary syndromic surveillance system. A copy of this data is submitted to CDC’s NSSP BioSense Platform. In July of 2017, NH worked with the NSSP vendor, CDC staff, a jurisdictional expert, NH Division of Information Technology staff, and an external vendor to create an “R” software download in CSV format and home-based NSSP Cognos report. This allowed NH DHHS staff to compare these data to the home-based data and ultimately, it proved to be an important step in the NSSP data quality assessment process.●Achieving success to improve data quality through collaborative Community of Practice partnerships The Data Quality Committee is a forum to identify, discuss, and attempt to address syndromic surveillance data quality issues. Maintaining data quality for the chief complaint field is a priority as it can impact the creation and refinement in the successful application of a syndrome definition for one of the fundamental data elements. An issue was observed in the Arizona data in the BioSense Platform, where chief complaint was being truncated at 200 characters. Through efforts to build relationships from the committee in the Community of Practice, Arizona was able to discover the root causes for the issue, assess if it affected other jurisdictions, and work with the partners to find a feasible resolution. This talk will discuss how this collaborative approach helped improve data quality.How the Moderator Intends to Engage the Audience in Discussions on the Topic: The moderator will introduce the session and the panelists, and will invite questions and comments from the audience.

scholarly journals The Financial Burden of Public Health Responses to Hepatitis A Cases Among Food Handlers, 2012-2014

2017 ◽  
Vol 132 (4) ◽  
pp. 443-447 ◽  
Author(s):  
Rebecca J. Morey ◽  
Melissa G. Collier ◽  
Noele P. Nelson
Keyword(s):  
Public Health ◽  
Hepatitis A ◽  
Health Department ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Food Handlers ◽  
The Mean ◽  
State And Local ◽  
Mean Cost

When food handlers become ill with hepatitis A virus (HAV) infection, state and local health departments must assess the risk of HAV transmission through prepared food and recommend or provide postexposure prophylaxis (PEP) for those at risk for HAV infection. Providing PEP (eg, hepatitis A [HepA] vaccine or immunoglobulin), however, is costly. To describe the burden of these responses on state and local health departments, we determined the number of public health responses to HAV infections among food handlers by reviewing public internet sources of media articles. We then contacted each health department to collect data on whether PEP was recommended to food handlers or restaurant patrons, the number of PEP doses given, the number of HepA vaccine or immunoglobulin doses given as PEP, and the mean number of health department person-hours required for the response. Of 32 public health responses identified from Twitter, HealthMap, and Google alerts from January 1, 2012, to December 31, 2014, a total of 27 (84%) recommended PEP for other food handlers or restaurant patrons or both. Per public health response, the mean cost per dose of the HepA vaccine or immunoglobulin was $34 139; the mean personnel cost per response was $7329; and the total mean cost of each response was $41 468. PEP is expensive. Less aggressive approaches to PEP, such as limiting PEP to fellow food handlers in nonoutbreak situations, should be considered in the postvaccination era. HepA vaccine for PEP provides long-term immunity and can be used when immunoglobulin is unavailable or cannot be administered within 14 days of exposure to HAV.

FOOD HANDLER TRAINING EVALUATION STUDIES IN CALIFORNIA*

1952 ◽  
Vol 15 (5) ◽  
pp. 233-237
Author(s):  
Ralph L. Tarbett
Keyword(s):  
Public Health ◽  
Training Program ◽  
Evaluation Studies ◽  
Health Department ◽  
The State ◽  
Food Handler ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Food Sanitation

The California Conference of Local Health Officers of a 1950 meeting requested the State Health Department to make a study of the effect of food handler training in a restaurant sanitation program. The Conference had previously gone on record as favoring education and inspection as desirable parts of a food sanitation program. This request, coupled with the questions passed by several sanitation directors of local health departments, “Will food handler training schools substantially improve sanitation in our restaurants?” caused the State Department of Public Health to enter upon these studies. Previous to the start of these studies, institutes on promoting and conducting food handler training programs had been held throughout the State. Guides which outlined the food handler courses had been distributed and widely accepted by local departments interested in food handler training. Consultants from the A.P.H.A., U.S.P.H.S., University of California School of Public Health, and Department of Public Health planned the methods, forms, and technique to be used in making this study. Field surveys of restaurants would be used as a base for measurements, State restaurant inspection personnel were used on the survey team. Each restaurant is given a numerical grade based on 100: 37 points for physical plant and 63 points for operational items. A rating is given the community using the U.S.P.H.S. method of scoring. Several types of communities were surveyed: (1) Those not having and not anticipating a food handler training program, (2) those not having, but developing a food handler training program, and (3) those having had a stable program for several years. This is developing a picture of the various types of communities. It is impossible to draw positive conclusions as to the value of food handler training on the basis of our studies up to the present time. However, it does appear, from the information thus far accumulated in a number of communities in the State of California, that food handler training does pay substantial dividends. These dividends appear to be in improved restaurant sanitation, better working relations between the restaurant industry and the local health department, and an increased public interest in and support for the program. Much of the criticism thrown at Health Departments regarding Food Sanitation is the lack of uniformity in recommended practices and legal interpretations of laws. These studies, we believe, in addition to measuring the value of food handler training courses, are also tending to standardize practices and legal interpretations and develop closer relationships between the State and local health departments.

Patterns of Cross-Sector Collaboration in Local Health Departments: A Cluster Analysis

2020 ◽  
pp. 152483992097298
Author(s):  
Alexis K. Grant
Keyword(s):  
Public Health ◽  
Cluster Analysis ◽  
Determinants Of Health ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Structural Determinants ◽  
Cluster Assignment ◽  
Cross Sectional ◽  
Top Executive

Local health departments (LHDs) are positioned to act as the community health strategist for their catchment area, which requires cross-sector collaboration. However, little research exists to understand how much and what types of cross-sector collaboration occur and its impact on LHD practice. Data from 490 LHDs who participated in the 2016 National Profile of Local Health Departments survey were analyzed to identify patterns of cross-sector collaboration among LHDs. In the survey, LHDs reported the presence of collaborative activities for each of 22 categories of organizations. Factor analysis was used to identify patterns in the types of organizations with which LHDs collaborate. Then, cluster analysis was conducted to identify patterns in the types of cross-sector collaboration, and cross-sectional analyses examined which LHD characteristics were associated with cluster assignment. LHDs collaborated most with traditional health care–oriented organizations, but less often with organizations focused on upstream determinants of health such as housing. Three distinct clusters represented collaboration patterns in LHDs: coordinators, networkers, and low-collaborators. LHDs who were low-collaborators were more likely to serve smaller populations, be unaccredited, have a smaller workforce, have a White top executive, and have a top executive without a graduate degree. These findings imply that public health practitioners should prioritize building bridges to a variety of organizations and engage in collaboration beyond information sharing. Furthermore, LHDs should prioritize accreditation and workforce development activities for supporting cross-sector collaboration. With these investments, the public health system can better address the social and structural determinants of health and promote health equity.

scholarly journals Actionable lessons for the US COVID vaccine program

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Gary L. Freed
Keyword(s):  
Public Health ◽  
Local Health ◽  
National Strategy ◽  
Individual State ◽  
Health Departments ◽  
Local Health Departments ◽  
Public Health Infrastructure ◽  
Health Infrastructure ◽  
The Us ◽  
Vaccine Distribution

AbstractWhen attempting to provide lessons for other countries from the successful Israeli COVID-19 vaccine experience, it is important to distinguish between the modifiable and non-modifiable components identified in the article by Rosen, et al. Two specific modifiable components included in the Israeli program from which the US can learn are (a) a national (not individual state-based) strategy for vaccine distribution and administration and (b) a functioning public health infrastructure. As a federal government, the US maintains an often complex web of state and national authorities and responsibilities. The federal government assumed responsibility for the ordering, payment and procurement of COVID vaccine from manufacturers. In designing the subsequent steps in their COVID-19 vaccine distribution and administration plan, the Trump administration decided to rely on the states themselves to determine how best to implement guidance provided by the Centers for Disease Control and Prevention (CDC). This strategy resulted in 50 different plans and 50 different systems for the dissemination of vaccine doses, all at the level of each individual state. State health departments were neither financed, experienced nor uniformly possessed the expertise to develop and implement such plans. A national strategy for the distribution, and the workforce for the provision, of vaccine beyond the state level, similar to that which occurred in Israel, would have provided for greater efficiency and coordination across the country. The US public health infrastructure was ill-prepared and ill-staffed to take on the responsibility to deliver > 450 million doses of vaccine in an expeditious fashion, even if supply of vaccine was available. The failure to adequately invest in public health has been ubiquitous across the nation at all levels of government. Since the 2008 recession, state and local health departments have lost > 38,000 jobs and spending for state public health departments has dropped by 16% per capita and spending for local health departments has fallen by 18%. Hopefully, COVID-19 will be a wakeup call to the US with regard to the need for both a national strategy to address public health emergencies and the well-maintained infrastructure to make it happen.

Application for Public Health Accreditation Among US Local Health Departments in 2013 to 2019: Impact of Service and Activity Mix

2020 ◽  
pp. e1-e8
Author(s):  
Jonathon P. Leider ◽  
Jessica Kronstadt ◽  
Valerie A. Yeager ◽  
Kellie Hall ◽  
Chelsey K. Saari ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Latent Class ◽  
The United States ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Profile Data ◽  
The Public ◽  
Funding Support

Objectives. To examine correlates of applying for accreditation among small local health departments (LHDs) in the United States through 2019. Methods. We used administrative data from the Public Health Accreditation Board (PHAB) and 2013, 2016, and 2019 Profile data from the National Association of County and City Health Officials to examine correlates of applying for PHAB accreditation. We fit a latent class analysis (LCA) to characterize LHDs by service mix and size. We made bivariate comparisons using the t test and Pearson χ2. Results. By the end of 2019, 126 small LHDs had applied for accreditation (8%). When we compared reasons for not pursuing accreditation, we observed a difference by size for perceptions that standards exceeded LHD capacity (47% for small vs 22% for midsized [P < .001] and 0% for large [P < .001]). Conclusions. Greater funding support, considering differing standards by LHD size, and recognition that service mix might affect practicality of accreditation are all relevant considerations in attempting to increase uptake of accreditation for small LHDs. Public Health Implications. Overall, small LHDs represented about 60% of all LHDs that had not yet applied to PHAB. (Am J Public Health. Published online ahead of print December 22, 2020: e1–e8. https://doi.org/10.2105/AJPH.2020.306007 )

scholarly journals Building Back Better: Local Health Department Engagement and Integration of Health Promotion into Hurricane Harvey Recovery Planning and Implementation

2019 ◽  
Vol 16 (3) ◽  
pp. 299 ◽  
Author(s):  
Mallory Kennedy ◽  
Shannon Gonick ◽  
Hendrika Meischke ◽  
Janelle Rios ◽  
Nicole Errett
Keyword(s):  
Disaster Recovery ◽  
Technical Assistance ◽  
Health Department ◽  
Decision Makers ◽  
Health Impacts ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Recovery Planning ◽  
Resilient Communities

Disaster recovery provides an opportunity to build healthier and more resilient communities. However, opportunities and challenges encountered by local health departments (LHDs) when integrating health considerations into recovery have yet to be explored. Following Hurricane Harvey, 17 local health and emergency management officials from 10 agencies in impacted Texas, USA jurisdictions were interviewed to describe the types and level of LHD engagement in disaster recovery planning and implementation and the extent to which communities leveraged recovery to build healthier, more resilient communities. Interviews were conducted between December 2017 and January 2018 and focused on if and how their communities were incorporating public health considerations into the visioning, planning, implementation, and assessment phases of disaster recovery. Using a combined inductive and deductive approach, we thematically analyzed interview notes and/or transcripts. LHDs reported varied levels of engagement and participation in activities to support their community’s recovery. However, we found that LHDs rarely articulated or informed decision makers about the health impacts of recovery activities undertaken by other sectors. LHDs would benefit from additional resources, support, and technical assistance designed to facilitate working across sectors and building resilience during recovery.

Analysis of the Current Status of Public Health Practice in Local Health Departments

1995 ◽  
Vol 11 (6) ◽  
pp. 51-54 ◽  
Author(s):  
Jane Suen ◽  
Gregory M. Christenson ◽  
Angela Cooper ◽  
Marcia Taylor
Keyword(s):  
Public Health ◽  
Public Health Practice ◽  
Current Status ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Health Practice
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