Held on June 19, 2019.
During this 90-minute session, Aaron Kite-Powell, M.S., from CDC and Wayne Loschen, M.S., from JHU-APL provided updates on the NSSP ESSENCE platform and answered the community's questions on ESSENCE functions and features.
ESSENCE
Description
Timely influenza data can help public health decision-makers identify influenza outbreaks and respond with preventative measures. DoD ESSENCE has the unique advantage of ingesting multiple data sources from the Military Health System (MHS), including outpatient, inpatient, and emergency department (ED) medical encounter diagnosis codes and laboratory-confirmed influenza data, to aid in influenza outbreak monitoring. The Influenza-like Illness (ILI) syndrome definition includes ICD-9 or ICD-10 codes that may increase the number of false positive alerts. Laboratory-confirmed influenza data provides an increased positive predictive value (PPV). The gold standard for influenza testing is molecular assays or viral culture. However, the tests may take 3-10 days to result. Rapid influenza diagnostic tests (RIDTs) have a lower sensitivity, but the timeliness of receiving a result improves to within <15 minutes. We evaluate the utility of RIDTs for routine ILI surveillance.
Objective: To describe influenza laboratory testing and results in the Military Health System and how influenza laboratory results may be used in DoD Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE)
Description
The ESSENCE system is a community-driven disease surveillance system. Installed in over 25 jurisdictions across the US, the system is built on a single codebase that is shared across all instances. While each individual location can customize many of the settings, data sources, and configurations, the underlying code and functionality is shared. This means that when one jurisdiction works with the Johns Hopkins University Applied Physics Laboratory (JHU/APL) to create a new feature, it is available to all sites.
Objective: The objective of this presentation is to discuss the new features that are under development for ESSENCE in 2019. This is a chance to describe the features, the use cases for the features, and open a dialogue with the community on potential new enhancements that are available.
Description
The data elements required for the proper functionality of VA’s ESSENCE system are all currently available within VA’s 128 VistA systems. These data are made available to VA’s ESSENCE system via a series of complicated MUMPS extraction routines, multiple data transformations crossing multiple servers, networks, operating systems and HL7-parsing routines on a daily interval. With recent changes emerging in VA’s information technology infrastructure, a new data architecture supporting ESSENCE’s surveillance capabilities is becoming possible.
Objective
To describe the new data warehouse, HAIISS Data Warehouse (HDW) architecture whereby VA’s Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE) will receive its required data elements from VA’s 128 VistA systems in a more accurate, robust and time sensitive manner.
Referenced File
Description
More than a decade ago, in collaboration with the U.S. Department of Defense, the Johns Hopkins University Applied Physics Laboratory (JHU/APL) developed the Electronic Surveillance System for the Early Notification of Community-based Epidemics (Enterprise ESSENCE), which is currently used by federal, state and local health authorities in the US. As emerging infections will most likely originate outside of the US (for example, SARS) the application of electronic biosurveillance is increasingly important in resource limited areas. In addition, such systems help governments respond to the recently modified International Health Regulations. Leveraging the experience gained in the development of Enterprise ESSENCE, JHU/APL has developed two freely available electronic biosurveillance systems suitable for use in resource-limited areas: Open ESSENCE (OE) and ESSENCE Desktop Edition (EDE).
Objective
This paper describes the development and early implementation of two freely available electronic biosurveillance software applications: OE, and EDE.
Referenced File
Description
Maryland has a powerful syndromic surveillance system, ESSENCE, which is used for the early detection of disease outbreaks, suspicious patterns of illness, and public health emergencies. ESSENCE incorporates traditional and nontraditional health indicators from multiple data sources (emergency department chief complaints, over-the-counter (OTC) medication sales, and poison control center data).
Initially, 15 (30%) acute care hospitals in the National Capital Region and Baltimore Metro Region of the state were sending emergency department (ED) data to ESSENCE. DHMH began planning several years ago to increase the number of hospitals reporting to ESSENCE.
In 2007, Maryland’s Governor introduced a homeland security initiative that outlined 12 Core Goals for A Prepared Maryland. One of core goals was to improve biosurveillance and in 2009, Maryland successfully incorporated 100% (45) acute-care hospitals into ESSENCE. Maryland continues to enhance and improve ESSENCE by incorporating additional data sources such as prescription medication data.
Objective
The purpose of this paper is to describe Maryland’s process of enhancing its Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) by incorporating additional data sources such as prescription medication data.
Referenced File
Description
Federal laws and national directives have focused attention on the development of more robust biosurveillance systems intended to detect events of public health interest in a timelier manner. Presidential Decision Directive 21 calls for integrated biosurveillance data, enhanced clinician awareness, and an epidemiologic surveillance system with sufficient flexibility to tailor analyses to new syndromes and emerging diseases. In 2007, a statewide syndromic surveillance system (ESSENCE) was implemented and hospitals were recruited to participate. Experience with ESSENCE in the context of the ED data analysis, visualization, and reporting prompted the exploration of integrating new data sources into ESSENCE and new analyses specific to these new data. The purpose of the ESSENCE system is now to provide an intuitive environment for state and local epidemiologists to conduct routine descriptive epidemiologic analysis, to monitor morbidity and mortality trends over time and space and across multiple data sources, thereby providing information that can assist with making decisions on how to improve population health.
Objective
Use of the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) in Florida has evolved from early event detection based on emergency department (ED) chief complaints to routine descriptive epidemiologic analysis, data visualization, and reporting across four different data sources, using and building on tools originally developed for syndromic surveillance.
Referenced File
Electronic public health surveillance serves an especially important function during mass events. Megan Patel, from the Cook County Department of Public Health (CCDPH), will discuss the use of the cloud-based ESSENCE system for situational awareness during the 2012 NATO Summit in Chicago, IL. This webinar will highlight improved functionality obtained via the cloud-based version of ESSENCE, as well as provide a real-life example of utilization.
The webinar will cover:
Description
Data streams related to case severity have been added to the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE), a disease-monitoring application used by the Department of Defense (DoD), as an additional analytic capability to alert the user when indications for events requiring expanded medical resources exist in clinical data streams. Commonly used indicators are admission and death, but fatalities are rare and many DoD clinics lack admitting capability, so we sought to derive additional severity indicators from outpatient records. This abstract describes the technical details and the thought process behind two novel derived indicators: Sick-in-Quarters (SIQ) and Escalating Care.
Objective
To evaluate new severity indicators that mimic a public health professional or clinician's judgment in determining the severity of a public health event when detected by a surveillance system.
Description
OpenMRS has global presence as an open source web based medical record system (MRS). It is built on an extensible, modular framework that allows the user to create a MRS that is as simple or complex as needed. OE is a multi-user network accessible analysis and visualization tool that enables users to monitor the populationÃs health from any computer connected to that network. OE was created as an open source solution using features and lessons learned from Enterprise ESSENCE, (Electronic Surveillance System for Early Notification of Community-Based Epidemics.) OE provides analyses, maps, graphs, charts, crosstabs, as well as detail tables and export functionality.
Objective
By pairing an open source medical record system, OpenMRS, with the Suite for Automated Global Electronic bioSurveillance (SAGES) disease surveillance tool, OpenESSENCE (OE), we have prototyped an open source solution for passive disease and program surveillance using an active medical record system.