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Daly Elizabeth

On 24 December 2009, a female New Hampshire resident was confirmed to have gastrointestinal anthrax on the basis of clinical findings and laboratory testing. Her source of anthrax was not immediately known, so the New Hampshire Department of Health and Human Services, in conjunction with several other state and federal agencies, conducted a comprehensive epidemiologic investigation, which included active surveillance to identify any additional anthrax cases from a similar exposure. It was determined that the index patient participated in a drumming event with animal-hide drums on 4 December, one day before the onset of symptoms. Two drums used at the event were later found to be contaminated with Bacillus anthracis.

 

Objective

This paper describes the use of customizable tools to query electronic emergency department data, as part of case finding, during the response to a community anthrax exposure in New Hampshire.

Referenced File
Submitted by hparton on

In response to the terrorist attack of September 11, 2001, the NH Department of Health and Human Services (NH DHHS) engaged state and external partners in the design of an early warning surveillance system to support bioterrorism and emergency preparedness. Initially, NH DHHS began collecting four syndrome counts from thirteen hospital Emergency Departments (ED) by fax. Automation began in 2002, when an over the counter (OTC) syndromic surveillance pilot system was implemented by Scientific Technologies Corporation (STC). In 2003-2004 this system, the Syndromic Tracking and Encounter Management System (STEMS), was expanded to include school absentee and occupational health reports. Over time, an internal Death Data application was automated to query vital record deaths, and in 2005 a real-time ED surveillance pilot, the Automated Hospital ED Data System (AHEDD), was developed by STC to replace manual ED surveillance. Over the past decade NH continued to expand the original concept with innovative approaches to identify undetected or under reported disease outbreaks.

Objective

To illustrate development of syndromic surveillance in NH, share innovation experience with the public health community, and contribute to the syndromic surveillance body of knowledge in the new public health Information Technology landscape.

Referenced File
Submitted by elamb on

In April 2009, a novel strain of influenza A was detected in Mexico, which quickly spread to the United States and the rest of the world. In response to the pandemic, the New Hampshire Department of Health and Human Services (NH DHHS) developed a web-based school absenteeism reporting system to track and record overall absenteeism and influenza-like-illness (ILI) related absenteeism in New Hampshire schools.

Objective

To monitor community illness and detect outbreaks during the 2009 influenza A/H1N1 pandemic using a newly developed surveillance system for monitoring school absenteeism.

Referenced File
Submitted by elamb on

Researchers have demonstrated benefits to identifying and developing interventions for patients that frequently seek healthcare services in the ED. The New Yorker Magazine, recently published an article titled The Hot Spotters, summarizing work being done in the United States to lower medical costs by giving the neediest patients better healthcare (1). In Camden, NJ, Physician Jeffrey Brenner closed his regular practice to focus on Hot Spotter patients (directing resources and brainpower to help their improvement) and measured a 40% reduction in hospital inpatient and ED visits and a 56% medical cost reduction for the first 36 Hot Spotters. A 2008 NH Office of Medicaid Business and Policy (OMBP) outpatient Medicaid ED frequency visit study was conducted, which cited that frequent ED users were more likely to have higher costs and rates of illness or disease than all Medicaid members (2). It was noted that increased prevention and wellness could reduce frequent ED use and increase cost savings (5% of the NH Medicaid population contributed to approximately 38% of ED costs). The NH Division of Public Health Services initiated a pilot project to examine NH Emergency Department (ED) surveillance data to identify high utilizer patients and realize improved health benefits and medical cost reductions.

Objective:

To develop a manageable surveillance methodology to detect Emergency Department (ED) patients with the highest healthcare utilization, and monitor their targeted treatment improvement and medical health cost reductions over time for overall improvements in statewide health.

 

Submitted by Magou on
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