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Powell Melissa

Description

Oregon Health Authority (OHA), in collaboration with the Johns Hopkins University Applied Physics Laboratory, recently implemented Oregon ESSENCE, an automated, electronic syndromic surveillance system. One way to strengthen syndromic surveillance is to include data from multiple sources. We are integrating data from emergency departments, state notifiable conditions and vital statistics, and the Oregon Poison Center (OPC). Implementing ESSENCE in Oregon provided the opportunity to automate poison center surveillance, which was previously done manually. In order to achieve this, OHA needed a daily data feed of OPC data to upload into Oregon ESSENCE servers. For OPC to do this directly, they would have incurred significant costs to develop the necessary electronic infrastructure to query and send the data; furthermore, OPC does not employ IT staff. OHA does not currently have funding available to support IT system interoperability with Oregon ESSENCE, so we sought a low-cost solution that would build upon existing systems that utilized the National Poison Data System (NPDS) web service.

Objective

Enhance Oregon ESSENCE by integrating data from the Oregon Poison Center (OPC) in a cost-effective manner.

Submitted by elamb on
Description

The Oregon Health Authority (OHA), in collaboration with the Johns Hopkins University Applied Physics Laboratory, implemented a syndromic surveillance system, Oregon ESSENCE. A critical component to developing and growing this statewide system is obtaining buy-in and voluntary participation from hospital Emergency Departments (EDs). This process involves approval at multiple levels within a hospital facility from administration to information technology staff responsible for sending electronic ED data to the Oregon ESSENCE system. Therefore, developing marketing materials that appeal to a wide range of recruitment audiences is a key step in obtaining stakeholder buy-in. OHA adopted the ISDS and CDC syndromic surveillance standards for the public health objective of the Center for Medicaid and Medicare Services (CMS) Meaningful Use Programs. However, Oregon hospitals will not receive financial incentive to participate in Oregon ESSENCE from CMS until 2014 during stage two of Meaningful Use. Consequently, this project's early years will focus on obtaining voluntary participation from hospitals.

 

Objective

Encourage hospitals to participate in OHA emergency department syndromic surveillance system, Oregon ESSENCE.

Submitted by elamb on

The Oregon ESSENCE team has developed a guide for other states to use to set up a web service link to their poison center and extract its data into ESSENCE. It contains advice based on Oregon’s experience in developing its link with its poison center and NDPS, a plug-&-play (almost) Rhapsody configuration file (and instructions) to install, and data dictionaries provided by NPDS.

The publication date is February 1, 2019.

Submitted by ctong on
Description

Oregon’s statewide syndromic surveillance system (Oregon ESSENCE) has been operational since 2012. Non-federal emergency department data (and several of their associated urgent care centers) are the primary source for the system, although other data sources have been added, including de-identified call data from OPC in 2016. OPHD epidemiologists have experience monitoring mass gatherings and have a strong relationship with OPC, collaborating on a regular basis for routine and heightened public health surveillance. Nevertheless, surveillance for the Great American Solar Eclipse (August 2017) presented a challenge due to the 107 reported simultaneous statewide eclipse-watching events planned for the day of the eclipse (some with estimated attendance of greater than 30,000 people and most in rural or frontier regions of the state). Scientific literature is limited on mass gathering surveillance in the developed world, particularly in rural settings, so OPC and OPHD worked together to develop a list of health conditions of interest, including some that would warrant both an ED visit and a call to OPC (e.g., snake bites). Monitoring visits in both data sources in would allow for assessment of total burden on the healthcare system, especially in the case of snake bites where only specific bites require administration of anti-venom.

Objective:

Identify surveillance priorities for emergency department (ED) and Oregon Poison Center (OPC) data ahead of the 2017 Great American Solar Eclipse gatherings in Oregon and create a suite of queries for use in the Health Intelligence Section of the Oregon Public Health Division (OPHD) Incident Management Team (IMT).

Submitted by elamb on
Description

The Great American Solar Eclipse of 2017 provided a rare opportunity to view a complete solar eclipse on the American mainland. Much of Oregon was in the path of totality and forecasted to have clear skies. Ahead of the event, OPHD aggregated a list of 107 known gatherings in mostly rural areas across the state, some with estimated attendance of up to 30,000 attendees. Temporary food vendors and a range of sanitation solutions (including open latrines) were planned. International travelers were expected, along with large numbers of visitors traveling by car on the day of the eclipse. The potential for multiple simultaneous mass gatherings across the state prompted OPHD to activate an incident management team (IMT) and to create a Health Intelligence Section to design a mass gathering surveillance strategy. Statewide syndromic surveillance (Oregon ESSENCE) has been used to monitor previous mass gatherings (1) and captures statewide emergency department (ED), urgent care, Oregon Poison Center, and reportable disease data.

Objective:

Develop a public health surveillance plan for the Oregon Public Health Division (OPHD) in anticipation of the expected influx of visitors for the 2017 Great American Solar Eclipse.

Submitted by elamb on
Description

Harmful algal blooms (HABs) consist of colonies of prokaryotic photosynthetic bacteria algae that can produce harmful toxins. The toxins produced by HABs are considered a One Health issue. HABs can occur in all types of water (fresh, brackish, and salt water) and are composed of cyanobacteria or microalgae. As the climate changes, so do many of the factors that contribute to the growth of HABs, which in turn, can increase the incidence of HAB-related illness in humans. There are three main pathways that HAB toxins can affect human health: dermal, gastrointestinal (GI), and neurological. Swimming in or consuming contaminated water and eating contaminated shellfish are ways to develop HAB-related illnesses. Contact with cells from a bloom while recreating can cause a rash on the body. Most commonly, HAB-related illnesses present with GI symptoms that resemble food poisoning and can affect the liver. Rarely, HABs that produce cyanotoxins can present with neurological symptoms. Issuing and lifting freshwater HAB advisories is within the preview of the Environmental Public Health section at the Oregon Public Health Division. However, most water bodies in the state are not monitored. Because of this, syndromic surveillance was considered as a potentially useful source of HAB exposure information, and the Oregon ESSENCE team was asked to develop a query to help monitor HAB-related complaints.

Objective:

Use ESSENCE to create a sustainable process for identifying ED and urgent care visits that may be related to harmful algal bloom exposure in Oregon.

Submitted by elamb on
Description

Wildfires occur annually in Oregon, and the health risks of wildfire smoke are well documented1. Before implementing syndromic surveillance through Oregon ESSENCE, assessing the health effects of wildfires in real time was very challenging. Summer 2015 marked the first wildfire season with 60 of 60 eligible Oregon emergency departments (EDs) reporting to ESSENCE. The Oregon ESSENCE team developed a wildfire surveillance pilot project with two local public health authorities (LPHAs) to determine their surveillance needs and practices and developed a training program to increase capacity to conduct surveillance at the local level. Following the training, one of the LPHAs integrated syndromic surveillance into its routine surveillance practices. Oregon ESSENCE also integrated the evaluation findings into the summer 2016 statewide wildfire surveillance plan.

Objective

To build capacity to conduct syndromic surveillance at the local level by leveraging a health surveillance need.

Submitted by Magou on
Description

The 2016 U.S. Olympic Track and Field Team Trials were held July 1-10 in Eugene, OR. This mass gathering included over 1,000 athletes, 1,500 volunteers, and 175,000 spectators. The Oregon Public Health Division (PHD) and Lane County Public Health (LCPH) participated in pre-event planning and collaborated to produce a daily epidemiology report for the Incident Management Team (IMT) during the event. The state and county public health agencies had collaborated on surveillance for prior mass gatherings, including the 2012 Trials. However, 2016 was the first opportunity to use complete state and county syndromic surveillance data. 

Objective

To streamline production of a daily epidemiology report including syndromic surveillance, notifiable disease, and outbreak data during a mass gathering. 

Submitted by Magou on