In the last decade, the scope of public health (PH) surveillance has grown, and biosurveillance capacity has expanded in Duval County. In 2004, the Duval County Health Department (DCHD) implemented a standalone syndromic surveillance (SS) system which required the manual classification and entry of emergency department (ED) chief complaints by hospital staff. At that time, this system, in conjunction with other external systems (e.g. CDC ILInet, FluStar, NRDM) were used to conduct surveillance for health events. Recommendations from a 2007 ISDS panel were used to strengthen surveillance within Duval County. Later that year, the Florida DOH moved to a statewide SS system and implemented ESSENCE which has been expanded to include 1) ED record data from 176 hospitals (8 within Duval County); 2) Reportable disease case records from Merlin; 3) Florida Poison Information Network consultations; and, 4) Florida Office of Vital Statistics death records (1). ESSENCE has subsequently become a platform for rapid data analysis, mapping, and visualization across several data sources (1). As a result, ESSENCE has improved business processes within DCHD well beyond the initial scope of event detection. These improvements have included 1) expansion of the ability to create visualizations (e.g. epi-curves, charts, and maps); 2) reduction in the time required to produce reports (e.g. newsletters, media responses); 3) reduction in staff training needs; and 4) augmentation of epidemiology processes (e.g. active case finding, emergency response, quality improvement (QI)), and closing the PH surveillance loop.
Objective
This paper reviews the evolution of biosurveillance in Duval County, FL and characterizes the subsequent improved execution of epidemiology functions as a result of the implementation of the Early Notification of Community-based Epidemics (ESSENCE) system.