This paper describes a simple technique for utilizing linked health information in syndromic surveillance. Using knowledge of which patient encounters resulted in laboratory test requests and prescriptions may improve sensitivity and specificity of detection algorithms.
Florida has implemented various surveillance methods to augment existing sources of surveillance data and enhance decision making with timely evidence based assessments to guide response efforts post-hurricanes. Historically, data collected from deployed federal assets have been an integral part of this effort. However, a number of factors have made this type of surveillance challenging: logistical is- sues of field work in a post-disaster environment, the resource inten- sive manual data collection process from DMAT sites, and delayed analysis and interpretation of these data to inform decision makers. The ESSENCE-FL system is an automated and secure web-based ap- plication accessed by FDOH epidemiologists and staff at participat- ing hospitals.
Objective
The Florida Department of Health (FDOH), Bureau of Epidemi- ology, partnered with the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR) to improve surveillance methods in post dis- aster or response events. A new process was implemented for con- ducting surveillance to monitor injury and illness for those presenting for care to ASPR assets such as Disaster Medical Assistance Team (DMAT) sites when they are operational in the state. The purpose of the current work was to field test and document the operational ex- perience of the newly implemented ASPR data module in ESSENCE- FL (syndromic surveillance system) to receive near real-time automated data feeds when ASPR federal assets were deployed in Florida during the 2012 Republican National Convention (RNC).
Hospital emergency departments in Cook and surrounding counties currently send data to the Cook County Department of Public Health (CCDPH) instance of ESSENCE on CCDPH servers. The cloud instance of ESSENCE has been enhanced to receive and export all meaningful use data elements in the meaningful use format. The NATO summit provided the opportunity for a demonstration project to assess the ability of an Amazon GovCloud instance of ESSENCE to ingest and process meaningful use data, and to export meaningful use surveillance data to the Cook County Locker in BioSense 2.0.
Objective
In May 2012, thousands of protesters, descended on Chicago during the NATO Summit to voice their concern about social and economic inequality. Given the increased numbers of international and domestic visitors to the Windy City and the tension surrounding protesting during the summit, increased monitoring for health events within the city and Chicago metropolitan region was advised. This project represents the first use of cloud technology to support monitoring for a high profile event.
In November of 2011 BioSense 2.0 went live to provide tools for public health departments to process, store, and analyze meaningful use syndromic surveillance data. In February of 2012 ESSENCE was adapted to support meaningful use syndromic surveillance data and was installed on the Amazon GovCloud. Tarrant County Public Health Department agreed to pilot the ESSENCE system and evaluate its performance compared to a local version ESSENCE they currently used. The project determined the technical feasibility of utilizing the Internet cloud to perform detailed public health analysis, necessary changes needed to support meaningful use syndromic surveillance data, and any public health benefits that could be gained from the technology or data.
Objective:
This project represents collaboration among CDC’s BioSense Program, Tarrant County Public Health and the ESSENCE Team at the Johns Hopkins University APL. For over six months the Tarrant County Public Health Department has been sending data through the BioSense 2.0 application to a pilot version of ESSENCE on the Amazon GovCloud. This project has demonstrated the ability for local hospitals to send meaningful use syndromic surveillance data to the Internet cloud and provide public health officials tools to analyze the data both using BioSense 2.0 and ESSENCE. The presentation will describe the tools and techniques used to accomplish this, an evaluation of how the system has performed, and lessons learned for future health departments attempting similar projects.
ASPR deploys clinical assets, including an EMR system, to the ground per state requests during planned and no-notice events. The analysis of patient data collected by deployed federal personnel is an integral part of ASPR and FDOH’s surveillance efforts. However, this surveillance can be hampered by the logistical issues of field work in a post-disaster environment leading to delayed analysis and interpretation of these data to inform decision makers at the federal, state, and local levels. FDOH operates ESSENCE-FL, a multi-tiered, automated, and secure web-based application for analysis and visualization of clinical data. The system is accessible statewide by FDOH staff as well as by hospitals that participate in the system. To improve surveillance ASPR and FDOH engaged in a pilot project whereby EMR data from ASPR would be sent to FDOH in near realtime during the 2012 hurricane season and the 2012 RNC. This project is in direct support of Healthcare Preparedness Capability 6, Information Sharing, and Public Health Preparedness Capability 13, Public Health Surveillance and Epidemiological Investigation.
Objective:
U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR) partnered with the Florida Department of Health (FDOH), Bureau of Epidemiology, to implement a new process for the unidirectional exchange of electronic medical record (EMR) data when ASPR clinical assets are operational in the state following a disaster or other response event. The purpose of the current work was to automate the exchange of data from the ASPR electronic medical record system EMR-S into the FDOH Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE-FL) system during the 2012 Republican National Convention (RNC).