Problem Summary
Data collection across a growing stream of contributing facilities and variables requires automated, consistent, and efficient monitoring of quality. Epidemiologists tasked with analyzing syndromic data need to be confident in the overall quality of their data, and aware of the effects of poor data quality when interpreting data. Data quality is also increasingly important as data are shared across jurisdictions and combined for analysis.
The Florida Department of Health electronically receives hospital emergency department (ED) data from 180 EDs located in 54 of its 67 counties through its Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE-FL). Florida EDs have begun to offer self-registration options to patients, which include ED self check-in kiosks, and pre-visit registration smartphone applications and websites. ESSENCE-FL receives ED data from multiple hospitals that use these patient self-registration methods. To date, limited investigation has been carried out to determine the impact of these self-registration methods on the data submitted to ESSENCE-FL. This project investigates and describes how SS data are affected by these options and provides possible best practices for identifying and analyzing these data.
Objective
To assess the effect of patient self-registration methods in hospital emergency departments on data in a syndromic surveillance (SS) system and provide suggestions for analysis of these data.
The March 2010 webinar of the ISDS Public Health Practice Committee gave an overview regarding how Florida is incorporating visualizations of their reportable disease data into their syndromic surveillance system. The presentation was followed by a general discussion regarding the need for and benefits of comparing - on a regular, systematic basis - reportable disease data and syndromic surveillance data.
Presenters
Aaron Kite-Powell, MS, Bureau of Epidemiology, Florida Department of Health
Date
Date
Monday, May 17, 2010
NTI's Global Health and Security Initiative joined ISDS to highlight the work of the Connecting Health Organizations for Regional Disease Surveillance (CHORDS) Project and what it is doing to address the challenges and opportunities of meeting IHR surveillance and response competencies around the world.
Presenters
Louise Greshman
Marlo Libel
Marjorie Pollack
Beverly Trayner
Host
ISDS Global Outreach Committee
Globally, disease surveillance systems suffer from a number of resource constraints. These constraints are more pronounced in developing countries, which bear the greatest burden of disease and where pathogens are more likely to emerge, reemerge, and mutate into drug-resistant strains (US-GAO August 2001). It has traditionally been difficult to monitor disease burden and trends in India, and even more difficult to detect, diagnose, and control outbreaks until they had become quite large (Suresh June 2003).
SyS systems have great potential to prevent morbidity, injury, and mortality by monitoring population health and providing realtime data to inform public health department decisions. Electronic health information technology and federal, state and local incentives and investments have helped to facilitate their rapid and widespread implementation. As a result, SyS systems operate in the context of laws and regulations that determine their success. An understanding of the effects of this legal environment is crucial to insuring that SyS systems fulfill their potential.
Objective
Explore the impact of law and government policy on the practice of syndromic disease surveillance (SyS) in the United States.
In Canada, the economic impact of unhealthy eating is estimated at $6.3 billion annually and in the US the estimated cost is $87 billion. Despite the critical need to identify effective diet-related interventions through empirical evaluation, public health practitioners and researchers lack timely access to representative data sources collected at a fine spatial and temporal resolution. Food surveys, for example, are costly, infrequent, delayed, and subject to biases.
The Nielsen Corporation collects data on food purchasing directly from scanners in grocery and convenience stores around the world. These data hold great potential for public health practice. We were interested in using these data to analyze purchases of regular (sugary) soda and water, before and after two interventions aimed at reducing sugary drink consumption. The first intervention, ‘Gobes-tu ça’, was a counter-advertising campaign targeting the age group with the highest consumption of soda, 12-17 year olds. The second intervention, ‘Sois-futé, bois santé’, targeted elementary school students. Both began in the Fall of 2011 and ramped up over time.
Objective
To demonstrate the utility of automatically captured store-level (i.e. point-of-sale) food purchasing data for the surveillance of dietary patterns before and after interventions. We assessed the effects of two interventions in Montreal, Canada that were intended to reduce the consumption of sugary drinks.
Achieving health equality is a national priority. The surveillance of health disparities in minority populations is key for the advancement of health equality. However, the need for improvement in documentation of race and ethnicity has been identified across various public health data sets. Currently, due to the lack of reporting of race and ethnicity in HDD, the NDHHS mainly depends on analyses of the statewide Behavioral Risk Factor Surveillance System and Vital Records data for the surveillance of health disparities among minority populations. An alternative data set that might help inform the surveillance of health disparities is SyS data. This near-real–time electronic health record data is characterized by required core data elements that provide information about the date and time of patient encounter, treating facility, clinical information, and patient demographics. Previously, we demonstrated statistically significant correlations between the 2011 and 2012 NDHHS ED SyS and ED HDD data for ICD9-CM ECODES corresponding to motor vehicle crash related injury, which is a relevant cause of health disparities. Our new objective was to determine the reporting consistency of ICD9-CM ECODES associated with other injury related health disparities between 2013 NDHHS SyS and HDD ED data. We also sought to determine if near-real–time ED and IP SyS data provide a more complete documentation of race and ethnicity than HDD.
Objective
This pilot study evaluates Nebraska Department of Health and Human Services (NDHHS) emergency department (ED) syndromic surveillance (SyS) data quality by cross-validating reported external cause of injury codes (ECODES) associated to racial/ethnic injury health disparities in Nebraska. The percent completeness of core data elements in SyS data and hospital discharge data (HDD) was also determined.
The majority of farmed animals are sent to slaughterhouses, making them a focal point for potential collection of health data. However, these data are not always available to health officials, and remain under-used for cattle health monitoring. Meat inspection data are mainly non-diagnostic (condemned portion and reasons for condemnation) and cover a large population. These characteristics make them a good candidate for syndromic surveillance. Whole carcass condemnation rate is linked to acute infections which reduces the dilution bias due to the variable period of time between cattle infection and the detection of lesions at the slaughterhouse.
Objective
The objective of the work was to assess the performance of several algorithms for outbreak detection based on weekly proportions of whole carcass condemnation
Near real-time emergency department chief complaint data is accessed through Florida’s syndromic surveillance system: Electronic Surveillance System for the Early Notification of Communitybased Epidemics-Florida (ESSENCE-FL). The Florida Department of Health relies heavily upon these data for timely surveillance of influenza and influenza-like illness (ILI). Hospital discharge data available from the Florida Agency for Health Care Administration (AHCA) captures information about influenza-associated ED visits and is considered complete. The delay in receiving the data (up to a year) hinders timely evidence-based decision making during the influenza season. Previous analyses (comparing the complete AHCA hospital discharge data to the ESSENCE-FL ILI syndrome and Influenza sub-syndrome) have shown ESSENCE-FL is a timely, effective tool to monitor influenza activity in the state and that the Influenza sub-syndrome most closely approximates influenza season activity in Florida. Adults > 65, pregnant women and children < 5 are at increased risk for morbidity and mortality from influenza infection. This investigation aims to determine if syndromic surveillance can be used to characterize in near real-time influenza infection in adults > 65, pregnant women, and children < 5 by comparing ED visits for influenza and ILI in ESSENCE-FL to historical AHCA records of people who incurred ED charges at a Florida hospital with diagnosed influenza.
Objective
To determine if emergency department (ED) based syndromic surveillance can be utilized to characterize in near real-time influenza infection in three high-risk populations: a) adults > 65, b) pregnant women, and c) children < 5.