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Lucero Cynthia

The Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) obtains electronic data from 153 Veterans Affairs (VA) Medical Centers plus outpatient clinics in all 50 states, American Samoa, Guam, Philippines, Puerto Rico, and U.S. Virgin Islands. Currently, there is no centralized VA reporting requirement for nationally notifiable infectious conditions detected in VA facilities. Surveillance and reporting of cases to local public health authorities are performed manually by VA Infection Preventionists and other clinicians. In this analysis, we examined positive predictive value of ICD-9-CM diagnosis codes in VA ESSENCE to determine the utility of this system in electronic detection of reportable conditions in VA.

 

Objective

To determine the utility of ICD-9-CM diagnosis codes in the VA ESSENCE for detection and public health surveillance of nationally notifiable infectious conditions in veteran patients.

Referenced File
Submitted by hparton on

On 20 April 2010, an explosion on an offshore drilling rig in the Gulf of Mexico led to a prolonged uncontrolled release of crude oil. Both clean-up workers and coastal residents were potentially at high risk for respiratory and other acute health effects from exposure to crude oil and its derivatives, yet there was no surveillance system available to monitor these health effects. The Department of Veterans Affairs (VA) conducts routine surveillance for biological threats using the Electronic Surveillance System for Early Notification of Community Based Epidemics (ESSENCE). ESSENCE captures specific patient care visit ICD-nine codes belonging to selected conditions that could represent a biological threat. VA operates 153 medical centers and over 1000 free standing patient care facilities across the United States. We describe the adaptation of ESSENCE to allow surveillance of health conditions potentially related to the oil spill.

 

Objective

To describe a surveillance system created to identify acute health issues potentially associated with the Deepwater Horizon oil spill among Veterans in the Gulf of Mexico coastal region.

Referenced File
Submitted by hparton on

The Veterans Health Administration (VHA) uses the Electronic Surveillance System for the Early Notification of Community-based Epidemics to detect disease outbreaks and other health-related events earlier than other forms of surveillance. Although Veterans may use any VHA facility in the world, the strongest predictor of which health care facility is accessed is geographic proximity to the patient's residence. A number of outbreaks have occurred in the Veteran population when geographically separate groups convened in a single location for professional or social events. One classic example was the initial Legionnaire's disease outbreak, identified among participants at the Legionnaire's convention in Philadelphia in the late 1970s. Numerous events involving travel by large Veteran (and employee) populations are scheduled each year.

 

Objective

To develop an algorithm to identify disease outbreaks by detecting aberrantly large proportions of patient residential ZIP codes outside a health care facility catchment area.

Referenced File
Submitted by elamb on

The VA has employed ESSENCE for health monitoring since 2006 [1]. Epidemiologists at the Office of Public Health (OPH) monitor the VA population at the national level. The system is also intended for facility-level monitoring to cover 152 medical centers, nearly 800 community-based outpatient clinics (CBOC), and other facilities serving all fifty states, the District of Columbia, and U.S. territories. For the entire set of facilities and current syndrome groupings, investigation of the full set of algorithmic alerts is impractical for the group of monitors using ESSENCE. Signals of interest may be masked by the nationwide alert burden. Customized querying features have been added to ESSENCE, but standardization and IP training are required to assure appropriate use.

Objective

The objective was to adapt and tailor the alerting methodology employed in the Electronic Surveillance System for Early Notification of Community-Based Epidemics (ESSENCE) used by Veterans Affairs (VA) for routine, efficient health surveillance by a small, VA headquarter medical epidemiology staff in addition to a nationwide group of infection preventionists (IPs) monitoring single facilities or facility groups.

Referenced File
Submitted by elamb on
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