Skip to main content

Schmit Kathryn

Description

The New York State (NYS) Medicaid Program provides healthcare for 34% of the population in New York City (NYC) and 4%-20% in each of the 57 county populations up-state. Prescription data are collected through the sub-mission of claims forms to the Medicaid Program and transmitted daily to the NYS Syndromic Surveillance Program as summary counts by drug category and patient’s ZIP Code, age category, and sex. One of the 18 drug categories is influenza agents, which in-cludes rimantadine, oseltamivir, and zanamivir.

For surveillance of influenza-like illness (ILI) activity, the NYS and NYC Sentinel Physician Influenza Surveillance Program collects from sentinel physicians weekly reports of the total number of patients seen and the number of patients presenting with ILI (defined as temperature > 100 degrees F, presence of cough or sore throat, and absence of other known cause of these symptoms). Not all counties in NYS have sentinel physicians: in the 2003-2004 flu surveillance season (Week 40, in early October, 2003, to Week 20, in late May, 2004), 37 of 57 upstate counties and all 5 counties of NYC had sentinel physicians.

 

Objective

To evaluate the usefulness of daily counts of prescriptions for influenza agents charged to Medicaid insurance, by county of residence of the recipient, for detection of elevated ILI in NYS, currently monitored through physicians participating in the CDC Influenza Surveillance Program.

Submitted by elamb on
Description

Following an Oct 12-13, 2006 snowstorm, almost 400,000 homes in western New York lost power, some for up to 12 days. News reports said that emergency rooms saw many patients with CO exposure; 3 deaths were attributed to CO poisoning. As part of NYS DOH’s syndromic surveillance system, electronic ED records with a free-text CC field listing the symptoms reported by the patient are sent to NYS DOH daily. Each CC is searched for text strings indicating complaints in one or more of 6 syndromes (asthma, fever, gastrointestinal (GI), neurological, respiratory, rash). The system also allows nonroutine searches of CCs for complaints of interest. NYS hospitals also submit ED records to the Statewide Planning and Research Cooperative System (SPARCS) that include diagnostic codes assigned after evaluation of the patient (due within 30 days of each calendar quarter).

Objective

To assess the ability to identify cases of carbon monoxide (CO) poisoning from chief complaints (CC) in hospital emergency department (ED) records submitted daily to the New York State (NYS) Department of Health (DOH) Electronic Syndromic Surveillance System.

Submitted by elamb on
Description

The Centers for Disease Control and Prevention BioSense has developed chief complaint (CC) and ICD9 sub syndrome classifiers for the major syndromes for early event detection and situational awareness. The prevalence of these sub-syndromes in the emergency department population and the performance of these CC classifiers have been little studied. Chart reviews have been used in the past to study this type of question but because of the large number of cases to review, the labor involved would be prohibitive. Therefore, we used an ICD9 code classifier for a syndrome as a surrogate by chart reviews to estimate the performance of a CC classifier.

 

Objective

To determine the prevalence of the sub-syndromes based on the ICD9 classifiers, and to determine the sensitivity, specificity, positive predictive value and negative predictive value of CC classifiers for the sub-syndromes associated with the respiratory and gastrointestinal syndromes using the ICD9 classifier as the criterion standard.

Submitted by elamb on
Description

The New York State Department of Health (NYSDOH) Syndromic Surveillance System consists of five components: 1. Emergency Department (ED) Phone Call System monitors unusual events or clusters of illnesses in the EDs of participating hospitals; 2. Electronic ED Surveillance System monitors ED chief complaint data; 3. Medicaid data system monitors Medicaid-paid over-the-counter and prescription medica-tions; 4. National Retail Data Monitor/Real-time Outbreak and Disease Surveillance System monitors OTC data; 5. CDC’s BioSense application monitors Department of Defense and Veterans Administration outpatient care clinical data (ICD-9-CM diag-noses and CPT procedure codes), and LabCorp test order data.

 

Objective

This poster presentation provides an overview of the NYSDOH Syndromic Surveillance System, including data sources, analytic algorithms, and resulting reports that are posted on the NYSDOH Secure Health Commerce System for access by state, regional, county, and hospital users.

Submitted by elamb on
Description

The New York State Department of Health (NYSDOH) currently applies EARS’s CuSum analyses to Medicaid Over the Counter and Prescription Medications data obtained from the Office of Medicaid Management's data warehouse. Daily drug category counts are compared with counts for a 7-day baseline period to generate C1, C2, and C3 signals for 62 counties and 8 Syndromic Surveillance Regions. Summary tables and graphs are posted on the NYSDOH Secure Health Commerce Network for access by state, regional, and county users.

The 7-day baseline CuSum method of analysis of syndromic surveillance databases can result in the generation of a large number of signals. Many signals are generated for counts that, upon manual review of 30-day or long-term trend graphs, are clearly within the range of normal daily variation and would not require follow up by public health authorities.

In order to prevent user desensitization to generated signals and minimize NYSDOH Syndromic Surveillance System end-user burden, supplemental measures that would indicate a daily count is higher than expected are currently being investigated.

 

Objective

To supplement CuSum analyses of syndromic surveillance databases within NYSDOH's Electronic Syndromic Surveillance System with other measures that would indicate a daily count is higher than expected in order to minimize the end-user burden of following up generated signals.

Submitted by elamb on
Description

The Centers for Disease Control and Prevention BioSense project has developed chief complaint (CC) and ICD9 sub-syndrome classifiers for the major syndromes for early event detection and situational awareness. This has the potential to expand the usefulness of syndromic surveillance, but little data exists evaluating this approach. The overall performance of classifiers can differ significantly among syndromes, and presumably among subsyndromes as well. Also, we had previously found that the seasonal pattern of diarrhea was different for patients < 60 months of age (younger) and for patients > 60 months of age (older).

 

Objective

Using chart review as the criterion standard to estimate the sensitivity, specificity, positive predictive value and negative predictive value of New York State hospital emergency department CC classifiers for patients < 60 months of age and > 60 months of age for the gastrointestinal (GI) syndrome and the following GI sub-syndromes: “abdominal pain”, “nausea-vomiting” and “diarrhea”.

Submitted by elamb on