Standards

Syndromic surveillance uses pre-diagnostic data to inform communicable disease prevention and control. Among health zones in the province of Alberta, Canada, practices employed by public health when using elementary school illness-cause absenteeism data vary widely.

Objective

The objective of this study was to carry out a mixed-methods evaluation of the ability of standardized supports to improve the usefulness of school absenteeism syndromic surveillance for public health in Alberta.

Health inequalities are major global public health problem and varies within and between countries. LMICs particularly India, are undergoing a phase of rapid economic development leading to an increase in informal settlements or urban slums. These settlements exhibits extreme poverty and suffers from adverse health outcomes. The worst affected are the adolescents because it is a crucial and most vulnerable age when health behaviours and lifestyle choices are established which affects their current and future health. The current health system in many of the developing countries are outdated and have either rudimentary health statistics or none. There is lack of standardized and reliable questionnaires to capture various behavioural aspects of subjective health of the population in India. Thus, we aim to identify various measures of determinants of social inequalities relevant to the Indian adolescent population context.

Objective

To identify and validate methods and scales measuring determinants of social inequalities in health in context to Indian adolescents. 

On October 1, 2015, the number of ICD codes will expand from 14,000 in version 9 to 68,000 in version 10. The new code set will increase the specificity of reporting, allowing more information to be conveyed in a single code. It is anticipated that the conversion will have a significant impact on public health surveillance by enhancing the capture of reportable diseases, injuries, and conditions of public health importance that have traditionally been the target of syndromic surveillance monitoring. For public health departments, the upcoming conversion poses a number of challenges, including: 1) Constraints in allocating resources to modify existing systems to accommodate the new code set, 2) Lack of ICD-10 expertise and training to identify which codes are most appropriate for surveillance, 3) Mapping syndrome definitions across code sets, 4) Limited understanding of the precise ICD-10 CM codes that will be used in the US Healthcare system, and 5) Adjusting for changes in trends over time that are due to transitions in usage of codes by providers and billing systems. To accommodate the ICD-9 to ICD-10 transition, the Centers of Disease Control and Prevention (CDC) partnered with the International Society of Disease Surveillance (ISDS) CoP to form a workgroup to develop the Master Mapping Reference Table (MMRT). This tool maps over 130 syndromes across the two coding systems to assist agencies in modifying existing database structures, extraction rules, and messaging guides, as well as revising established syndromic surveillance definitions and underlying analytic and business rules.

Objective

This roundtable will provide a forum for the syndromic surveillance Community of Practice (CoP) to discuss the public health impacts from the ICD-10-CM conversion, and to support jurisdictional public health practices with this transition. It will be an opportunity to discuss key impacts on disease surveillance and implementation challenges; and identify solutions, best practices, and needs for technical assistance.

Speed, reliability, and uniformity of data collection enable syndromic surveillance (SyS) systems to provide public health authorities (PHAs) with timely information about community health threats and trends. Increasingly, healthcare information technology (HIT) is being used to accelerate and automate data collection for more real-time surveillance, reducing irregularity in how SyS data are packaged and sent by healthcare providers. Continuing to focus on patient and population health outcomes, the on-going US federal program that certifies HIT to promote interoperability has mandated broader use of an updated standard for communication of SyS data. Under the Edition 2015 federal rule tied to Medicare and Medicaid reimbursement, hospitals, in addition to emergency departments and urgent care centers, are now required to provide SyS data to PHAs using HL7 2.5.1 messages that are in conformance with Release 2.0 of the CDC’s Public Health Information Network (PHIN) guide for SyS. To facilitate the intended application of this updated standard, a new version of conformance testing tools is being published, which will enable HIT developers to increase their probability of meeting the requirements outlined in the standard and lead to enhanced product interoperability and reliability.

Objective

Describe how the 2015 Edition of the National Institute of Standards and Technology’s (NIST) Syndromic Surveillance Messaging Validation Suite continues to support federal efforts to increase healthcare information technology interoperability for timelier public health surveillance in the US; and show how this tool is used to validate messages.

The National Biosurveillance Integration Center (NBIC) has the responsibility to integrate, analyze, and share the nation’s biosurveillance information provided from capabilities distributed across public and private sectors. The integration of information enables early warning and shared situational awareness of biological events to inform critical decisions directing response and recovery efforts.

Objective

To evaluate different government and commercial air travel route and volume data sources for utility in determining likely points of arrival and subsequent spread of communicable diseases originating from outbreaks outside the United States.

The CMS EHR Incentive Programs include a measure for meaningful use of EHR systems for submitting syndromic surveillance messages to public health. The Stage 2 measure defines the standard for transmission to be HL7 v2.5.1 Admit/Discharge/Transfer messages according to the PHIN Messaging Guide for Syndromic Surveillance and Conformance Clarification for EHR Certification of Electronic Syndromic Surveillance, Addendum to PHIN Messaging Guide for Syndrome Surveillance. The National Institute of Standards and Technology (NIST) provides an online testing tool for validating messages. While some jurisdictions use the Biosense platform for receiving, managing, and analyzing syndromic surveillance data, there is no consistent tool that is available to jurisdictions to assess the quality and conformance of data submissions both at the time of on-boarding a new reporting facility and on an ongoing basis during production operations.

The New York City Citywide Immunization Registry (CIR), the immunization information system for NYC that has been operational since 1997, has as part of its software suite an Open Source, webbased data quality assurance (QA) tool used by its research scientists to qualify new sites for reporting data electronically via HL7 v2 messages, and for monitoring the ongoing quality of data submissions over time. A validation process evaluates incoming messages against the rules established by an implementation guide (IG) and stores the result of the evaluation in a CIR database table that is accessible by the QA Tool which displays the data to an administrative user. This project served as a proof-of-concept for implementing a similar process for syndromic surveillance.

Objective

To leverage an existing open source quality assurance software tool created for the immunization domain and modify it to serve as a quality assurance tool for syndromic surveillance messages.

Cancer registration involves collecting information on patients with cancer. Population-based cancer registries in particular are useful in estimating the disease burden and to inform the institution of prevention and control measures. Collecting personal information on patients with cancer requires strict adherence to principles of confidentiality to ensure the safety of the collected data. Failure may have legal and medical implications. The Kumasi Cancer Registry was established as a population-based cancer Registry in 2012. The registry collects data on cases of cancer occurring among residents of the Kumasi Metropolitan area of Ghana. Issues bordering on confidentiality were an integral part of the establishment of the registry. We discuss the implementation of confidentiality plans during the four years of existence of the Kumasi Cancer Registry.

Objective

To discuss the implementation of confidentiality practices at the Kumasi Cancer Registry.