Ising Amy

NC DETECT receives ICD-9-CM codes for emergency department (ED) visits and uses these codes in case definitions for syndromic surveillance (e.g. infectious disease, injury, etc.). Hospitals will begin using ICD-10-CM codes on October 1, 2015. As a result, preparations have been made to accommodate ICD-10-CM codes in NC DETECT for data transmission, receipt, processing and use in the NC DETECT Web Application.

Objective

To describe lessons learned from the transition to ICD-10-CM.

Knowledge Management is defined as “the process of capturing, distributing, and effectively using knowledge.” ISDS members have varying degrees of experience with public health surveillance and syndromic surveillance specifically, and will all benefit from more structured access to documentation on components related to syndromic surveillance, including but not limited to, the onboarding of facilities, data quality monitoring tools, case definitions, and data processing tools. To build a knowledge management capability, the first step is to gather initial requirements and priorities from the CoP.

Objective

The purpose of the roundtable is to seek feedback from attendees on the components needed to improve syndromic surveillance practice through access to the shared knowledge, practices, and tools of the ISDS Community of Practice (CoP).

A local foundation commissioned a project to determine the leading causes of childhood injury in Wake County, NC. Multiple sources of secondary data, including syndromic surveillance data, were used to describe leading causes of childhood injury in the county.

Objective

To utilize secondary data sources to describe childhood injury and prioritize prevention efforts in Wake County, NC.

 

Per a frequently asked questions document on the ISDS website, approximately two thirds of HL7 records received in BioSense do not provide a Visit ID. As a result, BioSense data processing rules use the patient ID, facility ID and earliest date in the record to identify a unique visit. If the earliest dates in records with the same patient ID and facility ID occur within the same 24-hour time frame, those two visits are combined into one visit and the earliest date will be stored. The ED data sent by hospitals to NC DETECT include unique visit IDs and these are used to identify unique visits in NC DETECT. These data are also sent twice daily to BioSense. In order to assess the potential differences between the NC DETECT ED data in NC DETECT and the NC DETECT ED data in BioSense, an initial analysis of the 24-hour rule was performed.

Objective

NC DETECT emergency department (ED) data were analyzed to assess the impact of applying the BioSense “24-hour rule” that combines ED visits into a single visit if the patient ID and facility ID are the same and the earliest recorded dates occur within the same 24-hour time frame.

The advent of Meaningful Use (MU) has allowed for the expansion of data collected at the hospital level and received by public health for syndromic surveillance. The triage note, a free text expansion on the chief complaint, is one of the many variables that are becoming commonplace in syndromic surveillance data feeds. Triage notes are readily available in many ED information systems, including, but not limited to, Allscripts, Cerner, EPIC, HMS, MedHost, Meditech, and T-System. North Carolina’s syndromic surveillance system, NC DETECT, currently collects triage notes from 33 out of 122 hospitals in the State (27%), and this number is likely to increase.

Objective

This roundtable will provide a forum for the ISDS community to discuss the use of emergency department (ED) triage notes in syndromic surveillance. It will be an opportunity to discuss both the benefits of having this variable included in syndromic surveillance data feeds, as well as the drawbacks and challenges associated with working with such a detailed data field.

In 2012, an estimated 2.5 million people presented to the ED for a MVC injury in the U.S. National injury surveillance is commonly captured using E-codes. However, use of E-codes alone to capture MVC-related ED visits may result in a different picture of MVC injuries compared to using text searches of triage or chief compliant notes.

Objective

Identify and describe how the case definition used to identify MVC patients can impact results when conducting MVC surveillance using ED data. We compare MVC patients identified using external cause of injury codes (E-codes), text searches of triage notes and chief complaint, or both criteria together.

Recreational drug use is a major problem in the United States and around the world. Specifically, drug abuse results in heavy use of emergency department (ED) services, and is a high financial burden to society and to the hospitals due to chronic ill health and multiple injection drug use complications. Intravenous drug users are at high risk of developing sepsis and endocarditis due to the use of a dirty or infected needle that is either shared with someone else or re-used. It can also occur when a drug user repeatedly injects into an inflamed and infected site or due to the poor overall health of an injection drug user. The average cost of hospitalization for aortic valve replacement in USA is about $165,000, and in order for the valve replacement to be successful, patients must abstain from using drugs.

Objective

To describe how the state syndromic surveillance system (NC DETECT) was used to initiate near real time surveillance for endocarditis, sepsis and skin infection among drug users.