scholarly journals Adoption of Public Health Readiness Guidelines for Meaningful Use

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Eunice R. Santos ◽  
Wesley McNeely ◽  
Biru Yang ◽  
Raouf R. Arafat
Keyword(s):  
Public Health ◽  
Syndromic Surveillance ◽  
Gulf Coast ◽  
Meaningful Use ◽  
Health Department ◽  
Lessons Learned ◽  
Surveillance Systems ◽  
Syndromic Surveillance System ◽  
Related Data ◽  
Control And Prevention

ObjectiveTo describe the challenges and lessons learned for public healthand providers to successfully implement public health MeaningfulUse readiness guidelines and navigate from intent to submission ofproduction data while simultaneously upgrading surveillance systems.IntroductionThe Syndromic Surveillance Consortium of Southeast Texas(SSCSeT) consists of 13 stakeholders who represent 19 counties orjurisdictions in the Texas Gulf Coast region and receives health datafrom over 100 providers. The Houston Health Department (HHD)maintains and operates the syndromic surveillance system for the GulfCoast region since 2007. In preparation for Meaningful Use (MU) theHHD has adapted and implemented guidance and recommendationsfrom Centers for Disease Control and Prevention, Office of NationalCoordinator for Health Information Technology and others. HHDsgoal is to make it possible for providers meet MU specification byfacilitating the transmission of health related data for syndromicsurveillance. The timing of the transition into MU overlaps with thechange in syndromic surveillance systems.

Utility of Ambulance Data for Real-Time Syndromic Surveillance: A Pilot in the West Midlands Region, United Kingdom

2017 ◽  
Vol 32 (6) ◽  
pp. 667-672 ◽  
Author(s):  
Dan Todkill ◽  
Paul Loveridge ◽  
Alex J. Elliot ◽  
Roger A. Morbey ◽  
Obaghe Edeghere ◽  
...  
Keyword(s):  
United Kingdom ◽  
Real Time ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
Lessons Learned ◽  
Surveillance Systems ◽  
Preliminary Assessment ◽  
The West ◽  
Syndromic Surveillance System ◽  
West Midlands

AbstractIntroductionThe Public Health England (PHE; United Kingdom) Real-Time Syndromic Surveillance Team (ReSST) currently operates four national syndromic surveillance systems, including an emergency department system. A system based on ambulance data might provide an additional measure of the “severe” end of the clinical disease spectrum. This report describes the findings and lessons learned from the development and preliminary assessment of a pilot syndromic surveillance system using ambulance data from the West Midlands (WM) region in England.Hypothesis/ProblemIs an Ambulance Data Syndromic Surveillance System (ADSSS) feasible and of utility in enhancing the existing suite of PHE syndromic surveillance systems?MethodsAn ADSSS was designed, implemented, and a pilot conducted from September 1, 2015 through March 1, 2016. Surveillance cases were defined as calls to the West Midlands Ambulance Service (WMAS) regarding patients who were assigned any of 11 specified chief presenting complaints (CPCs) during the pilot period. The WMAS collected anonymized data on cases and transferred the dataset daily to ReSST, which contained anonymized information on patients’ demographics, partial postcode of patients’ location, and CPC. The 11 CPCs covered a broad range of syndromes. The dataset was analyzed descriptively each week to determine trends and key epidemiological characteristics of patients, and an automated statistical algorithm was employed daily to detect higher than expected number of calls. A preliminary assessment was undertaken to assess the feasibility, utility (including quality of key indicators), and timeliness of the system for syndromic surveillance purposes. Lessons learned and challenges were identified and recorded during the design and implementation of the system.ResultsThe pilot ADSSS collected 207,331 records of individual ambulance calls (daily mean=1,133; range=923-1,350). The ADSSS was found to be timely in detecting seasonal changes in patterns of respiratory infections and increases in case numbers during seasonal events.ConclusionsFurther validation is necessary; however, the findings from the assessment of the pilot ADSSS suggest that selected, but not all, ambulance indicators appear to have some utility for syndromic surveillance purposes in England. There are certain challenges that need to be addressed when designing and implementing similar systems.TodkillD, LoveridgeP, ElliotAJ, MorbeyRA, EdeghereO, Rayment-BishopT, Rayment-BishopC, ThornesJE, SmithG. Utility of ambulance data for real-time syndromic surveillance: a pilot in the West Midlands region, United Kingdom. Prehosp Disaster Med. 2017;32(6):667–672.

scholarly journals What did Syndromic Surveillance Show During London 2012? Lessons for Mass Gatherings

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Dan Todkill ◽  
Helen Hughes ◽  
Alex Elliot ◽  
Roger Morbey ◽  
Obaghe Edeghere ◽  
...  
Keyword(s):  
Public Health ◽  
General Practitioner ◽  
Syndromic Surveillance ◽  
Lessons Learned ◽  
Surveillance Systems ◽  
Mass Gathering ◽  
Daily Number ◽  
Mass Gatherings ◽  
London 2012 ◽  
The Impact

This paper investigates the impact of the London 2012 Olympic and Paralympic Games on syndromic surveillance systems coordinated by Public Health England. The Games had very little obvious impact on the daily number of ED attendances and general practitioner consultations both nationally, and within London. These results provide valuable lessons learned for future mass gathering events.

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.

Public Health in the Field and the Emergency Operations Center: Methods for Implementing Real-Time Onsite Syndromic Surveillance at Large Public Events

2013 ◽  
Vol 7 (5) ◽  
pp. 467-474 ◽  
Author(s):  
Kristen Pogreba-Brown ◽  
Kyle McKeown ◽  
Sarah Santana ◽  
Alisa Diggs ◽  
Jennifer Stewart ◽  
...  
Keyword(s):  
Public Health ◽  
Syndromic Surveillance ◽  
Prediction Models ◽  
Health Department ◽  
The United States ◽  
Study Data ◽  
Public Health Response ◽  
Syndromic Surveillance System ◽  
Patient Reports ◽  
Public Events

AbstractObjectiveTo develop an onsite syndromic surveillance system for the early detection of public health emergencies and outbreaks at large public events.MethodsAs the third largest public health jurisdiction in the United States, Maricopa County Department of Public Health has worked with academic and first-response partners to create an event-targeted syndromic surveillance (EVENTSS) system. This system complements long-standing traditional emergency department-based surveillance and provides public health agencies with rapid reporting of possible clusters of illness.ResultsAt 6 high profile events, 164 patient reports were collected. Gastrointestinal and neurological syndromes were most commonly reported, followed by multisyndromic reports. Neurological symptoms were significantly increased during hot weather events. The interview rate was 2 to 7 interviews per 50 000 people per hour, depending on the ambient temperature.DiscussionStudy data allowed an estimation of baseline values of illness occurring at large public events. As more data are collected, prediction models can be built to determine threshold levels for public health response.ConclusionsEVENTSS was conducted largely by volunteer public health graduate students, increasing the response capacity for the health department. Onsite epidemiology staff could make informed decisions and take actions quickly in the event of a public health emergency. (Disaster Med Public Health Preparedness. 2013;0:1–8)

Framework for the Development of Response Protocols for Public Health Syndromic Surveillance Systems: Case Studies of 8 US States

2009 ◽  
Vol 3 (S1) ◽  
pp. S29-S36 ◽  
Author(s):  
Lori Uscher-Pines ◽  
Corey L. Farrell ◽  
Steven M. Babin ◽  
Jacqueline Cattani ◽  
Charlotte A. Gaydos ◽  
...  
Keyword(s):  
Public Health ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
The United States ◽  
Essential Elements ◽  
System Response ◽  
Surveillance Systems ◽  
Health Departments ◽  
Public Health Response ◽  
Syndromic Surveillance System

ABSTRACTObjectives: To describe current syndromic surveillance system response protocols in health departments from 8 diverse states in the United States and to develop a framework for health departments to use as a guide in initial design and/or enhancement of response protocols.Methods: Case study design that incorporated in-depth interviews with health department staff, textual analysis of response plans, and a Delphi survey of syndromic surveillance response experts.Results: All 8 states and 30 of the 33 eligible health departments agreed to participate (91% response rate). Fewer than half (48%) of surveyed health departments had a written response protocol, and health departments reported conducting in-depth investigations on fewer than 15% of syndromic surveillance alerts. A convened panel of experts identified 32 essential elements for inclusion in public health protocols for response to syndromic surveillance system alerts.Conclusions: Because of the lack of guidance, limited resources for development of response protocols, and few examples of syndromic surveillance detecting previously unknown events of public health significance, health departments have not prioritized the development and refinement of response protocols. Systems alone, however, are not effective without an organized public health response. The framework proposed here can guide health departments in creating protocols that will be standardized, tested, and relevant given their goals with such systems. (Disaster Med Public Health Preparedness. 2009;3(Suppl 1):S29–S36)

scholarly journals Evaluating the application and utility of ESSENCE for early event detection

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Allison K. Kunerth ◽  
Elizabeth Baker ◽  
Alan Zelicoff ◽  
Michael Elliot ◽  
Kevin Syberg
Keyword(s):  
Public Health ◽  
Event Detection ◽  
Syndromic Surveillance ◽  
Early Event ◽  
Surveillance Systems ◽  
User Characteristics ◽  
Syndromic Surveillance System ◽  
Local Public Health ◽  
Public Health Agencies ◽  
Surrounding Areas

ObjectiveA mixed methods study is being conducted on the statewide EarlyNotification of Community Based Epidemics (ESSENCE) systemin Missouri to identify factors that can improve the timeliness andidentification of outbreaks. This research will provide stakeholderswith guidance on how best to implement and improve ESSENCEusage statewide, and by sharing this research input can be solicitedon the utility of the applied framework as well as future implicationsfrom this body of work.IntroductionIn spite of the noted benefits of syndromic surveillance, andmore than a decade after it started gaining support, the primary usefor syndromic surveillance appears to be largely for seasonal andjurisdictional disease monitoring, event response and situationalawareness as opposed to its intended purpose of early event detection.(1-4) Research assessing the user characteristics and standards appliedat local public health agencies (LPHA’s) for syndromic surveillanceare scarce, and in national surveys epidemiologists frequently tendto utilize their own syndromic surveillance systems as opposed toa national system such as Biosense. While the National SyndromicSurveillance Program (NSSP) has addressed many operationalconcerns from stakeholders, and is in the process of providing accessto the cloud based Biosense platform-along with ESSENCE as a keytool, there is still a paucity of research that exists as to what can bedone to improve the utilization of syndromic surveillance systems forits primary purpose of early event detection.MethodsThis research proposes to evaluate the use of ESSENCE withinMissouri and the surrounding areas, to comprehensively identifyits strengths and limitations, through an assessment of the userexperience. This research will evaluate three key areas: 1) thequality of the data received by the syndromic surveillance system,2) the characteristics of the individuals and organizations utilizingthe system (end-users), 3) the influence and extent of syndromicsurveillance data on public health actions. ESSENCE data will beevaluated directly with special attention to the top three data qualityattributes across the literature, completeness, accuracy and timeliness.(5) A survey will also be administered to ESSENCE system users andpublic health leadership at LPHA’s, to gain insight into perspectives,perceptions and general practices, as well as how they interact withdata from ESSENCE.ResultsThe data for this research is primarily being collected throughoutthe fall of 2016, so the hope is to bring preliminary data to thisconference as a means to validate some of the findings, solicit inputon the proposed framework and share this research in a timely mannerfor the NSSP roll out of Biosense and ESSENCE.ConclusionsThrough a thorough evaluation, the application and utility ofESSENCE for early event detection will be better understood, alongwith the identification of factors that can be targeted in the future(and across syndromic surveillance platforms) for improvement in thetimely identification of outbreaks.

Developing a new syndromic surveillance system for the London 2012 Olympic and Paralympic Games

2012 ◽  
Vol 140 (12) ◽  
pp. 2152-2156 ◽  
Author(s):  
S. E. HARCOURT ◽  
J. FLETCHER ◽  
P. LOVERIDGE ◽  
A. BAINS ◽  
R. MORBEY ◽  
...  
Keyword(s):  
Public Health ◽  
General Practice ◽  
General Practitioner ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
Surveillance Systems ◽  
Syndromic Surveillance System ◽  
National System ◽  
London 2012 ◽  
Paralympic Games

SUMMARYSyndromic surveillance is vital for monitoring public health during mass gatherings. The London 2012 Olympic and Paralympic Games represents a major challenge to health protection services and community surveillance. In response to this challenge the Health Protection Agency has developed a new syndromic surveillance system that monitors daily general practitioner out-of-hours and unscheduled care attendances. This new national system will fill a gap identified in the existing general practice-based syndromic surveillance systems by providing surveillance capability of general practice activity during evenings/nights, over weekends and public holidays. The system will complement and supplement the existing tele-health phone line, general practitioner and emergency department syndromic surveillance systems. This new national system will contribute to improving public health reassurance, especially to meet the challenges of the London 2012 Olympic and Paralympic Games.

scholarly journals Syndromic surveillance: two decades experience of sustainable systems – its people not just data!

2019 ◽  
Vol 147 ◽  
Author(s):  
Gillian E. Smith ◽  
Alex J. Elliot ◽  
Iain Lake ◽  
Obaghe Edeghere ◽  
Roger Morbey ◽  
...  
Keyword(s):  
Public Health ◽  
Real Time ◽  
Syndromic Surveillance ◽  
Situational Awareness ◽  
Clinical Signs ◽  
Added Value ◽  
Surveillance Systems ◽  
Public Health Action ◽  
Related Data ◽  
The Impact

AbstractSyndromic surveillance is a form of surveillance that generates information for public health action by collecting, analysing and interpreting routine health-related data on symptoms and clinical signs reported by patients and clinicians rather than being based on microbiologically or clinically confirmed cases. In England, a suite of national real-time syndromic surveillance systems (SSS) have been developed over the last 20 years, utilising data from a variety of health care settings (a telehealth triage system, general practice and emergency departments). The real-time systems in England have been used for early detection (e.g. seasonal influenza), for situational awareness (e.g. describing the size and demographics of the impact of a heatwave) and for reassurance of lack of impact on population health of mass gatherings (e.g. the London 2012 Olympic and Paralympic Games).We highlight the lessons learnt from running SSS, for nearly two decades, and propose questions and issues still to be addressed. We feel that syndromic surveillance is an example of the use of ‘big data’, but contend that the focus for sustainable and useful systems should be on the added value of such systems and the importance of people working together to maximise the value for the public health of syndromic surveillance services.

scholarly journals Coordinated Enhanced Surveillance with Healthcare Entities for Mass Gathering Events

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Erin E. Austin
Keyword(s):  
Public Health ◽  
Syndromic Surveillance ◽  
Lessons Learned ◽  
Surveillance Systems ◽  
Mass Gathering ◽  
Functional Requirements ◽  
Specific Field ◽  
Mass Gatherings ◽  
Ed Visits ◽  
The U.S

ObjectiveTo describe the planning strategies and lessons learned by theVirginia Department of Health (VDH) when conducting enhancedsurveillance during mass gathering events and coordinating withhealthcare entities to distinguish event-related emergency department(ED) visits from community-related ED visits.IntroductionMass gatherings can result in morbidity and mortality fromcommunicable and non-communicable diseases, injury, andbioterrorism. Therefore, it is important to identify event-related visitsas opposed to community-related visits when conducting publichealth surveillance1. Previous mass gatherings in Virginia havedemonstrated the importance of implementing enhanced surveillanceto facilitate early detection of public health issues to allow for timelyresponse2.MethodsBetween June 2015 and September 2015, VDH coordinatedwith two healthcare entities representing six acute care hospitalsto conduct enhanced surveillance for the 2015 World Police andFire Games and 2015 Union Cycliste Internationale (UCI) RoadWorld Championships. VDH established initial communicationwith each healthcare entity between 1 week to 2 months before theevent start date to discuss functional requirements with technical,informatics, and clinical staff. Requirements included: 1) health careentity identifying gathering attendees during the ED registration, 2)capturing a standardized mass gathering indicator within the patient’selectronic health record (EHR), and 3) transmitting the gatheringindicator to VDH through existing electronic syndromic surveillancereporting processes. ED visit records with the gathering indicator wereanalyzed by VDH using the Virginia Electronic Surveillance Systemfor the Notification Community-based Epidemics (ESSENCE) andfindings were incorporated in daily VDH situational reports. Thissame methodology will be applied for the upcoming U.S. VicePresidential Debate in October 2016.ResultsThe duration of the two gatherings in 2015 ranged from 9 to 10 daysand the locations were categorized as urban. The population densityof the gathering location ranged from 1,950 to 2,889 populationper square mile. The estimated number of attendees ranged from45,000 to 400,000. Attendees were defined as having attended at leastone day of the mass gathering event. The mass gathering indicatorcaptured during the ED registration included the gathering acronymor a gathering specific field with a drop down menu containingtrue/false options. VDH utilized ESSENCE to identify 42 ED visits(0.5%) with the gathering acronym out of 8,768 total ED visits duringthe 2015 World Police and Fire Games and 60 ED visits (2.6%)with the gathering specific field out of 2,296 total visits during the2015 UCI Road World Championships. The results of the U.S. VicePresidential Debate in October 2016 are pending.ConclusionsIn 2015, VDH partnered with two healthcare entities to conductenhanced surveillance during two mass gatherings. Although VDHroutinely uses syndromic surveillance data to identify issues of publichealth concern, it has previously lacked the ability to identify EDvisits specific to mass gatherings. Prior to collaboration with VDH,the healthcare entities did not capture gathering-specific ED visitsusing their EHR systems. The two healthcare entities successfullymodified their business procedures and EHR system to capture andtransmit a gathering indicator for ED visits despite some challenges.These challenges include constraints with customization of theEHR and syndromic surveillance systems, lack of standardizedtraining among ED registration staff for interpreting and applyingthe gathering indicator, and limited functionality testing prior tothe event. Lessons learned from this coordinated effort are to: 1)initiate the planning phase and identification of requirements as earlyas possible to ensure they are well defined and understandable, 2)implement frequent communications with the healthcare entity,and 3) customize requirements for the specific gathering as muchas possible while balancing the burden and benefit to public healthand the healthcare entity. The coordinated enhanced surveillanceefforts provided both VDH and the healthcare entities with improvedsituational awareness and capacity building during mass gatheringevents. The strategies and lessons learned from these two events willbe applied to improve enhanced surveillance of public health issuesduring future mass gatherings, including the U.S. Vice PresidentialDebate in October 2016.

scholarly journals Integrating Poison Center Data into Oregon ESSENCE using a Low-Cost Solution

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Robert Laing
Keyword(s):  
Public Health ◽  
Web Service ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
Low Cost ◽  
Primary Data ◽  
Poison Center ◽  
Clinical Effects ◽  
Syndromic Surveillance System ◽  
Related Data

ObjectiveTo enhance Oregon ESSENCE’s surveillance capabilities byincorporating data from the Oregon Poison Center using limitedresources.IntroductionOregon Public Health Division (OPHD), in collaboration with theJohns Hopkins University Applied Physics Laboratory, implementedOregon ESSENCE in 2012. Oregon ESSENCE is an automated,electronic syndromic surveillance system that captures emergencydepartment data. To strengthen the capabilities of Oregon ESSENCE,OPHD sought other sources of health-outcome information, includingOregon Poison Center (OPC). In the past, Oregon’s surveillance staffmanually monitored OPC data on the National Poison Data Service(NPDS) website. Although functional, it was not integrated intoOregon’s syndromic surveillance system and required epidemiologiststo assess alerts on individual calls. To achieve data integration,OPHD pursued an automated solution to deliver OPC data intoOregon ESSENCE. OPHD’s growing interoperability infrastructurefostered development of a low-cost, reliable solution to automate theintegration of these data sources.MethodsOPC facilitated OPHD’s access to the free-of-charge NPDS webservice with an approval request and a data use agreement. OPHDuses the Rhapsody Integration Engine 6.2.1 (Orion Health, Auckland,NZ) as its primary data transfer and translation mechanism. OPHDleveraged its existing Rhapsody installation to automatically requestdata from the NPDS web service daily. Each request contains customsearch parameters that query calls from the previous day (24 hours).The service returns an XML file containing poison center call datawith multiple nodes of related data. Rhapsody uses a JavaScript ‘filter’to parse each call and its related data. The Oregon ESSENCE backendSQL database contains a parent table for the call and child tables forthe related data (Clinical Effects, Routes, Scenarios, Therapies, andGeneric Codes). Rhapsody inserts data into each of these backendSQL tables.ResultsOregon ESSENCE displays OPC data through its web interface forinterpretation by OPHD’s syndromic surveillance epidemiologists.Integrating NPDS data into Oregon ESSENCE allows OPHD staffto timely monitor data in an automated, routine manner. Syndromicsurveillance staff first assess alerts generated by Oregon ESSENCE.Alerts that require follow-up trigger a call between OPHDepidemiologists and OPC. Oregon is the first state to use the NPDSweb service to upload poison center data into Oregon ESSENCE.ConclusionsOregon’s successful integration of the NPDS web service data intoOregon ESSENCE is the first known of its kind. It leverages OPHD’sgrowing infrastructure of interoperability software applications andstaff expertise to create a cost-effective and sustainable solution thatcan be easily adapted by other public health agencies.

Sign in / Sign up

Export Citation Format

Share Document