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Karras Bryant

During the 2009 H1N1 influenza pandemic, the Washington State Department of Health (DOH) temporarily made lab-confirmed influenza hospitalizations reportable. Reporting of influenza hospitalizations is resource intensive for hospitals and local health jurisdictions. As a result, electronic sources of influenza hospitalization data are being explored. A Regional Health Information Exchange (HIE) in Washington currently sends DOH ICD9 coded discharge diagnoses and microbiology laboratory orders and results for all patients admitted to 17 hospitals throughout Washington, including four of the five hospitals in Spokane County. The HIE hospitalization and laboratory data may be a valuable replacement for mandatory notifiable condition reporting to monitor the basic epidemiology and severity of influenza in Washington.

Objective

To evaluate the sensitivity, positive predictive value (PPV), timeliness, completeness, and representativeness of lab-confirmed influenza hospitalization data from a health information exchange with respect to traditional notifiable condition reporting.

Referenced File
Submitted by elamb on

The CDC's BioSense 2.0 system is designed with a user-centered approach, where the needs and requests of the users are part of its continued development. User requirements were gathered extensively to help design BioSense 2.0 and users continue to submit feedback which is used to make improvements to the system. However, in order to ensure that these needs are gathered in a formal and ongoing way, the BioSense 2.0 Governance Group, comprised primarily of state and local public health representatives, was established to advise the CDC on the development of BioSense 2.0. The Governance Group (GG) understands that to make recommendations having direct relevance and utility to the community, they must engage public health jurisdictions which use BioSense 2.0. To that end, the GG has conducted three surveys of the BioSense 2.0 community. The survey results will help inform the group's prioritized recommendations to the CDC.

Objective

In this presentation we discuss the findings and lessons learned from these surveys.

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The University of Washington has been working since 2000 with partners in Washington State to advance bioterrorism (BT) detection and preparedness. This project collects data on patients presenting with influenza-like illnesses and other potentially BT-related syndromes at emergency departments and primary care clinics (Kitsap, Clallam, and Jefferson counties) using a secure automated informatics approach. Local health jurisdiction epidemiologists use a web-based interface to view de-identified data and use a version of CDC’s EARS disease detection algorithms to watch for variances in patterns of diagnoses, volume, time and space as part of the public health real-time disease surveillance system. This processed hospital data is also made available back to the officials and administrators at the reporting hospital.

 

Objective

To understand GIS issues in a rural-tourban setting and demonstrate limitations of ZIPcode-only approaches compared to census tract and block approaches.

Referenced File
Submitted by elamb on

The University of Washington's Center for Public Health Informatics, in collaboration with the Kitsap County Health District and the UW Clinical Informatics Research Group, has developed the Peninsula Syndromic Surveillance Information Collection System (SSIC), a complex second-generation [1,2] distributed database system which collects heterogeneous data from three emergency department / urgent care facilities computerized electronic admission and discharge diagnosis data. We transform heterogeneous institution-specific data to a standardized XML (eXtensible Markup Language) format, which is then transmitted to and integrated into a central database. Aberration detection algorithms are used to analyze this data so that public health officials can detect higher-than-usual incidences of the clinical syndromes under surveillance.

Referenced File
Submitted by elamb on

Under the CDC STD Surveillance Network (SSuN) Part B grant, WA DOH is testing eICR of sexually transmitted infections (STI) with a clinical partner. Existing standard vocabulary codes were identified to represent previously-identified information gaps, or the need for new codes or concepts was identified.

Objective:

Previous research identified data gaps between traditional paper-based STI notifiable condition reporting and pilot electronic initial case reporting (eICR) relying on Continuity of Care Documents (CCDs) exported from our clinical partner’s electronic health record (EHR) software. Structured data capture is needed for automatic processing of eICR data imported into public health repositories and surveillance systems, similar to electronic laboratory reporting (ELR). Coding data gaps (between paper and electronic case reports) using standardized vocabularies will allow integration of additional questions into EHR or other data collection systems and may allow creation of standard Clinical Data Architecture (CDA) templates, Logical Observation Identifiers Names and Codes (LOINC) panels, or Fast Healthcare Interoperability Resources (FHIR) resources. Furthermore, identifying data gaps can inform improvements to other standards including nationwide standardization efforts for notifiable conditions.

Submitted by elamb on

This year’s conference theme is “Harnessing Data to Advance Health Equity” – and Washington State researchers and practitioners at the university, state, and local levels are leading the way in especially novel approaches to visualize health inequity and the effective translation of evidence into surveillance practice.

Objective

Washington is leading the way in especially novel approaches. Our goal is to share some of these innovative methods and discuss how these are used in State and Local monitoring of Health

 

Submitted by Magou on

Washington State experienced a five-fold increase in deaths from unintentional drug overdoses between 1998 and 2014. The PMP collects data on controlled substances prescribed to patients and makes the data available to healthcare providers, giving providers another tool for patient care and safety. Optimal impact for the program depends on providers regularly accessing the information to review patients’ dispensing history. We have found through provider surveys and work with stakeholders that the best way to increase use is to make data seamlessly accessible through electronic health record systems (EHRs). This approach does not require a separate login to the PMP portal. This linkage works through the Health Information Exchange (HIE) to make PMP data available to providers via EHRs. The HIE facilitates electronic communication of patient information among organizations including hospitals and providers. In addition to the PMP, another resource to address the prescription drug abuse problem is the Emergency Department Information Exchange (EDIE), a web-based technology that specifically connects emergency departments statewide to track patients who visit multiple EDs. We also developed a connection between EDIE and PMP data through the HIE.

Objective

Demonstrate that use of the Washington State health information exchange (HIE) to facilitate access to prescription monitoring program (PMP) data enhances the effectiveness of a PMP. The increased accessibility will lead to improved patient care by giving providers more complete and recent data on patients’ controlled substance prescriptions.

Submitted by elamb on
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