Surveillance Systems

This report describes an exploratory analysis of the 2009-2010 Zimbabwe measles outbreak based on data publicly available in the World Health Organization's Zimbabwe cholera epidemiological bulletin archive. As of December 12th 2010, the outbreak appears to have ended after it is suspected to have caused 13,783 infections, 693 of those being confirmed IgM positive, and 631 deaths.

Objective

To systematically organize the World Health Organization data on the 2010 measles outbreak in Zimbabwe. To perform a post-hoc exploratory analysis to understand how the outbreak spread geographically and evaluate the effectiveness of a mass vaccination campaign.

The Government of Indonesia (GoI) aims to eliminate Malaria by 2030 in 4 stages (Wismarini, 2009. To reach the elimination phase High Case Incidence (HCI) areas go through a pre-elimination phase. The aim of the proposed project is to support one of the Stage 3 provinces in reaching the pre-elimination phase by 2015, and to assist its HCI districts and municipalities in re-orienting their programs to malaria elimination. The pre-elimination phase can be attained by following these evidence-based technical strategies: (1) Prompt & accurate diagnosis of cases; (2) Prompt treatment with effective medicines, including intermittent preventive treatment in pregnancy (IPTp); (3) Selective, targeted & integrated vector control; and, (4) Emergency & epidemic preparedness. (Olumese, 2008).

Objective

To seek collaboration with international research institutions and funding agencies.

Triple-S (Syndromic Surveillance Survey, Assessment towards Guidelines for Europe) was launched in 2010 for a 3-year period. Co-financed by the European Commission through the Executive Agency for Health and Consumers, the project is coordinated by the French Institute for Public Health Surveillance and involves 24 organisations from 13 countries. Both human and veterinary syndromic surveillance are considered.

Objective

The first results of the inventory of syndromic surveillance systems in Europe, conducted in the framework of the European project Triple-S, are presented.

In Reunion Island, the non-specific surveillance was developed since 2006 and was based on the activity of only one hospital emergency department and on mortality. To respond to the threat of influenza A(H1N1) pandemic emergence, this surveillance system was significantly enhanced. All hospital emergency departments of the island have been included as well as the emergency medical service regulation center. In 2010, a new surveillance was implemented from National Health Insurance data.

Objective

To demonstrate that the different surveillance systems allow to establish complementary indicators.

Most outbreaks are small and localized in nature, although it is larger outbreaks that result in the most public attention. So a solution to manage an outbreak has to be able to accommodate a response to small outbreaks in a single jurisdiction scalable up to outbreaks that involve thousands of cases across multiple jurisdictions and to handle different types of situations with different questions and response required. To make this happen, information and resources need to be shared more consistently and efficiently to help facilitate the communication that occurs at all levels and to support day-to-day operations in order to ensure consistent use.

Objective

1.To provide a flexible solution to perform an outbreak investigation by improving communications during an incident.

2.To provide all users with a common set of data for decision support.

3.To provide standard forms for a consistent approach and to improve data quality.

There is national recognition of the need for cross-programmatic data and system coordination and integration for surveillance, prevention, response, and control implementation. To accomplish this public health must develop an informatics competency and create an achievable roadmap, supported by performance measures, for the future. Within the New York State Department of Health, Office of Public Health (OPH), a cross-organizational and cross-functional Public Health Information Management Workgroup (PHIM-WG) was formed to align public health information and technology goals, objectives, strategies, and resources across OPH. In June 2011, the OPH Performance Management Initiative, funded by the Centers for Disease Control and Prevention, offered strategic planning workshops to PHIM-WG.

Objective 

To develop strategic objectives necessary to optimize the collection, integration, and use of information across public health programs and internal and external partners for improving the overall health and safety of people and their communities.

The critical need for population-level interventions to support the health needs of the growing population of older adults is widely recognized1. In addition, there is a need for novel indicators to monitor wellness as a resource for living and a means for prediction and prevention of changes in community health status2. Smart homes, defined as residential infrastructure equipped with technology features that enable passive monitoring of residents to proactively support wellness, have the potential to support older adults for independence at the residence of their choice. However, a characterization of the current state of smart homes research as a population health intervention is lacking. In addition, there is a knowledge translation gap between the smart homes research and public health practice communities. The EBPH movement identifies three types of evidence along a continuum to inform population health interventions: Type 1 (something should be done), Type 2 (this should be done) and Type 3 (how it should be done)3. Type 2 evidence consists of a classification scheme for interventions (emerging, promising, effective and evidence-based)3. To illustrate typology use with an example: the need for population health interventions for aging populations is well known (Type 1 evidence), many studies show that smart home technologies can support aging in place (Type 2 evidence) but there are few, if any, examples of smart homes as population health interventions to support aging in place (Type 3 evidence). Our research questions for this systematic review are: 1) What categories of Type 2 evidence from the scientific literature uphold smart homes as an EBPH intervention? 2) What are the novel health indicators identified from smart home studies to inform design of a community health registry that supports prediction and prevention of negative changes in health status? 3) What stakeholders are reported in studies that contribute Type 2 evidence for smart homes as an EBPH intervention? 4) What gaps exist between Type 2 and Type 3 evidence for smart homes as an EBPH intervention?

Objective

This study aims to 1) characterize the state of smart homes research as a population health intervention to support aging in place through systematic review and classification of scientific literature using an evidence-based public health (EBPH) typology and 2) identify novel indicators of health captured by monitoring technologies to inform design of a community health registry.

Although the advent of the ONCs "meaningful use" criteria has added significant new incentives for healthcare organizations to provide the necessary data for implementing syndromic surveillance, incentives alone are not sufficient to sustain a robust community of practice that engages public health and healthcare practitioners working together to fully achieve meaningful use objectives. The process for building a successful community of practice around syndromic surveillance is primarily application-agnostic. The business process has many of the same characteristics regardless of application features, and can be incrementally customized for each community based on the unique needs and opportunities and the functional characteristics of the application. This presentation will explore lessons-learned in the north central Texas region with BioSense 1 and ESSENCE over the past six years, and will describe the multi-phase process currently underway for BioSense 2.0. Key program process steps and success criteria for public health and healthcare practitioners will be described. This road map will enable other local health department jurisdictions to replicate proven methodologies in their own communities. The presentation will also highlight what it takes for an existing community of practice with a home grown system to move processes and protocols to the cloud.

Objective

To explore the lessons learned from the Advanced Practice Center methodology regarding the implementation of syndromic surveillance while considering what it takes to create, enhance, and sustain relationships between hospitals, public health practitioners, and the community.

Mobile technology provides opportunities to monitor and improve health in areas of the world where resources are scarce. Poor infrastructure and the lack of access to medical services for millions have led to increased usage of mobile technology for health related purposes in recent years. As adoption has increased, so has its acceptance as a viable technology for health data collection. The ability to provide timely, accurate, and informed responses to emerging outbreaks of disease and other health threats makes mobile technology highly suitable for use in surveillance data collection activities and within the arena of global health informatics overall. The American Public Health Association defines global health informatics as the application of information and communication technologies to improve health in low-resource settings, which include the following: linking disparate sources of data together through natural language processing, use of mobile health technologies for disease surveillance, use of telemedicine to manage chronic disease, use of digital libraries to increase knowledge and awareness of public health events. 

Objective 

To present the prevailing global public health informatics landscape in developing countries highlighting current mobile system requirements and usage for disease surveillance and revealing gaps in the technology.

The American Recovery and Reinvestment Act (ARRA) initiated a broad range of national implementation activities. In order to support the critical activities of meaningful use (MU), ONC established the S&I Framework. In the beginning of 2011 the Laboratory Reporting Interface (LRI) Public Health (PH) Work Group (WG) was formed as a subworking group of the S&I Framework LRI activity. This LRI PH WG, besides providing PH required data elements to the LRI, assessed a need for assessment of the broad landscape of public health laboratory data exchange transactions. As a result, this WG recommended to participants and leadership of the ONC S&I that a new initiative, the ONC S&I PHR activity should be established. In July 2011 a team of public health practitioners, (co-authors of this presentation) started working on a charter and use cases for the group.

Objective

The objective of this presentation is to evaluate progress on harmonization of public health electronic data exchange through the Public Health Reporting (PH-R) Standards and Interoperability (S&I) Framework activity.