This paper describes a simple technique for utilizing linked health information in syndromic surveillance. Using knowledge of which patient encounters resulted in laboratory test requests and prescriptions may improve sensitivity and specificity of detection algorithms.
Presented July 20, 2018.
VA is the U.S. federal agency responsible for providing services to America’s Veterans. Within VA, VHA is the organization responsible for administration of health care services. VHA, with 152 Medical Centers and over 900 outpatient clinics located throughout the U.S. and territories, provided care to over 5 million patients in 2011. After the 2009 H1N1 influenza pandemic, OSP, which oversees VA senior level briefing of preparedness issues, conceptualized and initiated SMEC-bio as a protocol-based mechanism to incorporate timely VHA subject matter expertise into leadership decision making via the VA IOC. Previous work has examined collection and integration of data from VA and interagency sources for trend and predictive analyses (1). This current work is an initial assessment of SMEC-bio reporting, which has been in development for the past year and functions on an ad hoc basis for decision support; needs and gaps can be assessed toward a formalized communication plan with the VA IOC.
Objective
To assess Reports sent from the United States VA Subject Matter Expertise Center for Biological Events (SMEC-bio) – a proof-of concept decision support initiative – to the VA Integrated Operations Center (VA IOC).
There is growing interest in leveraging available health information exchange (HIE) infrastructures to improve public health surveillance (1). The Health Information Technology for Clinical and Economic Health Act and Meaningful Use criteria for electronic health record (EHR) systems are among the factors driving the development, adoption and use of HIEs. HIEs deliver or make accessible clinical and administrative data as patients are admitted, discharged, and transferred across hospitals, clinics, medical centers, counties, states and regions (2). While several HIE infrastructures exist (3), there is little evidence on the engagement in HIE initiatives by state and local health agencies.
Objective
To characterize state and local health agency relationships with health information exchange organizations.
For a number of years, the federal government has provided biosurveillance in various domains within different departments and agencies. Congress recognized the need for a means of integrating these separate information sources into a more useable resource by chartering NBIC within the Department of Homeland Security.
Objective:
Enhance knowledge of the vision, mission, strategic goals, and objectives of the National Biosurveillance Integration Center (NBIC). Learn about innovative biosurveillance projects ongoing in NBIC.
Public health practice that prevents, detects, and responds to communicable and noncommunicable disease threats is hindered by poor access to public health data and information. This includes timely sharing of case-based information, respecting patent and publication rights, and the ethical sharing of specimens. Disagreements about information shared and under what circumstances plus who has right to the data, clinical specimens, and their derivative products impede research and countermeasures. Delayed or inaction by public health authorities undermines trust and exacerbates the crisis. Evident in 2014 by the delayed Public Health Emergency of International Concern declaration of the Ebola virus outbreak in West Africa by the World Health Organization, the governing presumption is that access to public health information should be restricted, constrained, or even hoarded; this is a failed approach. This lack of transparency prevents information availability when and where it is needed and obstructs public health efforts to efficiently and ethically prevent, detect, and respond to emerging threats. A better way forward is to reverse this presumption in favour of open public health information properly vetted and openly accessible. Open public health information is a critical step to revitalize public health practice and is a human right. While there is limited global consensus among scientists and public health practitioners on best practices to guide national health authorities, researchers, NGOs, and industry as they navigate the ethical, political, technical, and economic challenges associated with the sharing of essential public health information (e.g., pathogen isolates, clinical specimens, and patient-related data), grounding this discussion on the guiding principles of open public health information can help navigate the complex privacy, security, communication, and access needs, and ensure that collaboration and sharing occur in a manner that is ethically and socially just, efficient, and equitable. Built on existing governance frameworks such as the International Health Regulations (IHRs) and the Pandemic Influenza Preparedness Framework (PIP), open public health can transform public health surveillance, allowing for the rapid sharing of data and products during outbreaks for mutual benefit and enhanced global health security.
Objective:
The goal of this editorial is to shed light on the lack of transparency that exists in the sharing of Public Health data and to reverse this presumption in favour of open public health information properly vetted and openly accessible. Open public health information is a critical step to revitalize public health practice and is a human right.
With increasing awareness of SyS systems, there has been a concurrent increase in demand for data from these systems â both from researchers and from the media. The opioid epidemic occurring in the United States has forced the SyS community to determine the best way to present these data in a way that makes sense while acknowledging the incompleteness and variability in how the data are collected at the hospital level and queried at the user level. While significant time and effort are spent discussing optimal queries, responsible presentation of the data - including data disclaimers - is rarely discussed within the SyS community.
Objective:
To discuss data disclaimers and caveats that are fundamental to sharing syndromic surveillance (SyS) data
Disease surveillance systems remain the best quality systems to rely on when standardized surveillance systems provide the best data to understand disease occurrence and trends. The United States National Tuberculosis Surveillance System (NTSS) contains reported tuberculosis (TB) cases provided by all 50 states, the District of Columbia (DC), New York City, Puerto Rico, and other U.S.-affiliated jurisdictions in the Pacific Ocean and Caribbean Sea. However, the NTSS currently captures phenotypic drug susceptibility testing (DST) data and does not have the ability to collect the rapid molecular DST data generated by platforms such as Cepheid GeneXpert MTB/RIF, Hain MTBDRplus and MTBDRsl, Pyrosequencing, and Whole Genome Sequencing. Moreover, the information exchanges within the NTSS (represented in HL7 v2.5.1) are missing critical segments for appropriately representing laboratory test results and data on microbiological specimens.
Objective:
The objective of this presentation is to use a congruence of standardization protocols to effectively ensure that the quality of the data elements and exchange formats within the NTSS are optimal for users of the system.
Prior to June 2016, there were 45 registered users of syndromic surveillance data in Washington State, with 29 (64.4%) representing 5 of Washingtonâs 35 local health jurisdictions and 16 (35.6%) at the state level. Of those registered users, 9 (8.8%) had logged into ESSENCE at least once in the 6 months before October 2016. In June 2016, the Washington State syndromic surveillance program began accepting Meaningful Use data and sought to increase its user base. To accomplish this, the Washington State Department of Health (WA DOH) designated a staff member to oversee outreach efforts to increase the visibility of syndromic data in the state, including the establishment of a Community of Practice.
Objective:
To grow and facilitate a community of syndromic surveillance data users in Washington State, improving and expanding local syndromic practice.
One of the more recent successes of NSSP has been the introduction of more robust data quality monitoring and reporting. However, despite the increased insight into data quality, there are still concerns about data sharing and comparisons across sites. For NSSP to be most effective, users need to feel confident in sharing data and making comparisons across sites.
Objective:
As the BioSense Platform matures and more sites submit surveillance data, many in the community have voiced concerns about comparing data across sites. Recently, a number of jurisdictions from across the country were asked to provide opioid overdose data to a news agency highlighting the epidemic. Many jurisdictions requested information on how to present syndromic surveillance data from across sites and shared concern about how the data would be interpreted. This round table will address those concerns and explore options for comparing data across sites.