In 2007-2008, the authors surveyed public health officials in 59 state, territorial, and selected large local jurisdictions in the United States regarding their conduct and use of syndromic surveillance. Fifty-two (88%) responded, representing areas comprising 94% of the United States population. Forty-three (83%) of the respondents reported conducting syndromic surveillance for a median of 3 years (range = 2 months to 13 years). Emergency department visits were the most common data source, used by 84%, followed by outpatient clinic visits (49%), over-the-counter medication sales (44%), calls to poison control centers (37%), and school absenteeism (35%). Among those who provided data on staffing and contract costs, the median number of staff dedicated to alert assessment was 1.0 (range 0.05 to 4), to technical system maintenance 0.6 (range zero to 3); and, among the two-thirds who reported using external contracts to support system maintenance, median annual contract costs were $95,000 (range = %5,500 to $1 million). Respondents rated syndromic surveillance as most useful for seasonal influenza monitoring, of intermediate usefulness for jurisdiction-wide trend monitoring and ad hoc analyses, and least useful for detecting typical community outbreaks. Nearly all plan to include syndromic surveillance as part of their surveillance strategy in the event of an influenza pandemic. Two thirds are either "highly" or "somewhat" likely to expand their use of syndromic surveillance within the next 2 years. Respondents from three state health departments who reported they did not conduct syndromic surveillance noted that local health departments in their states independently conducted syndromic surveillance. Syndromic surveillance is used widely throughout the United States. Although detection of outbreaks initially motivated investments in syndromic surveillance, other applications, notably influenza surveillance, are emerging as the main utility.
Soper Paula
Public health is at a precipice of increasing demand for the consumption and analysis of large amounts of disparate data, the centralization of local and state IT offices, and the compartmentalization of programmatic technology solutions. Public health informatics needs differ across programmatic areas, but may have commonalities across jurisdictions. Initial development of the PHCP was launched with the goal of providing a shared infrastructure for state and local jurisdictions enabling the development of interoperable systems and distributed analytical methods with common sources of data. The PHCP is being designed to leverage recent successes with cloud-based technology in public health.
Success of the PHCP is dependent on the involvement of state and local public health jurisdictions in the transparent development and future direction of the platform. Equally critical to success is the selection of appropriate technology, consideration of various governance structures, and full understanding of the legal implications of a shared platform model.
Objective
To update the public health practice community on the continuing development of the Public Health Community Platform (PHCP).
Spurred by recent advances in PH informatics, the implementation of the Medicare and Medicaid Electronic Health Records Incentive Programs (Meaningful Use), and the opportunities provided by the availability of the redesigned BioSense program, SyS has become an increasingly important component of the biosurveillance enterprise. Knowing how and when jurisdictions use SyS, as well as challenges faced, allows ISDS, ASTHO, CDC, and other partners to provide relevant CBA – information transfer, training, and technical assistance – to further biosurveillance practice.
Objective
To present the results of a nationwide survey designed to assess the syndromic surveillance (SyS) practices and capacity-building assistance (CBA) needs of U.S. state public health authorities (PHAs).
One of ASTHO’s key goals is to help its jurisdictions meet member needs for technical assistance, including making informed decisions about their syndromic surveillance options. To help them make such decisions, ASTHO worked with Booz Allen to create a decision analysis model, which factors in both a Value of Information (VOI) model and a Return on Investment (ROI) model. The model provides a dashboard of its outputs, which is a simple, easy-to-understand comparative view of multiple syndromic surveillance investment scenarios.
Objective
Provide a demonstration of the recently developed prototype decision analysis model for syndromic surveillance investments. The roundtable will be used to discuss the model, obtain feedback on its usefulness, and brainstorm future uses and improvements.
The PHCP is a community-led initiative to provide shared infrastructure, services, and applications to the public health community as solutions for complex public health informatics problems. The project has progressed by establishing a governance structure led by an executive committee representative of the public health practice community. The executive committee has established the strategic path for the continued development of the PHCP and prioritized eCR as the initial use case for implementation.
Objective
To inform the community on the progress of electronic case reporting (eCR) utilizing the shared infrastructure and applications of the Public Health Community Platform (PHCP).