Block 3 of the US Military Electronic Surveillance System for Early Notification of Community-Based Epidemics (ESSENCE) system affords routine access to multiple sources of data. These include administrative clinical encounter records in the Comprehensive Ambulatory Patient Encounter Record (CAPER), records of filled prescription orders in the Pharmacy Data Transaction Service, developed at the Department of Defense (DoD) Pharmacoeconomic Center, Laboratory test orders and results in HL7 format, and others. CAPER records include a free-text Reason for Visit field, analogous to chief complaint text in civilian records, and entered by screening personnel rather than the treating healthcare provider. Other CAPER data fields are related to case severity. DoD ESSENCE treats the multiple, recently available data sources separately, requiring users to integrate algorithm results from the various evidence types themselves. This project used a Bayes Network approach to create an ESSENCE module for analytic integration, combining medical expertise with analysis of 4 years of data using documented outbreaks.
Objective
The project objective was to develop and test a decision support module using the multiple data sources available in the U.S. DoD version of ESSENCE.