BioSurveillance

Public health disease surveillance is defined as the ongoing systematic collection, analysis and interpretation of health data for use in the planning, implementation and evaluation of public health, with the overarching goal of providing information to government and the public to improve public health actions and guidance. Since the 1950s, the goals and objectives of disease surveillance have remained consistent. However, the systems and processes have changed dramatically due to advances in information and communication technology, and the availability of electronic health data. At the intersection of public health, national security and health information technology emerged the practice of syndromic surveillance.

Objective

Review of the origins and evolution of the field of syndromic surveillance. Compare the goals and objectives of public health surveillance and syndromic surveillance in particular. Assess the science and practice of syndromic surveillance in the context of public health and national security priorities. Evaluate syndromic surveillance in practice, using case studies from the perspective of a local public health department.

The nation’s first operational infectious disease forecast station, modeled after warning protocols developed in the meteorology community, was activated in 2011. The approach was originally pioneered in Haiti following the 2010 earthquake.

Objective:

To evaluate the sociological effect on indigenous biological event signature recognition and community resilience due to the operational activities of an infectious disease forecast station.

 

Local, national, and global infectious disease surveillance systems have been implemented to meet the demands of monitoring, detecting, and reporting disease outbreaks and prevalence. Varying surveillance goals and geographic reach have led to multiple and disparate systems, each using unique combinations of data streams to meet surveillance criteria. In order to assess the utility and effectiveness of different data streams for global disease surveillance, a comprehensive survey of current human, animal, plant, and marine surveillance systems and data streams was undertaken. Information regarding surveillance systems and data streams has been (and continues to be) systematically culled from websites, peer-reviewed literature, government documents, and subject-matter expert consultations.

Objective:

The goal of this project is to identify systems and data streams relevant for infectious disease biosurveillance. This effort is part of a larger project evaluating existing and potential data streams for use in local, national, and international infectious disease surveillance systems with the intent of developing tools to provide decision-makers with timely information to predict, prepare for, and mitigate the spread of disease.

 

Health care information is a fundamental source of data for biosurveillance, yet configuring EHRs to report relevant data to health departments is technically challenging, labor intensive, and often requires custom solutions for each installation. Public health agencies wishing to deliver alerts to clinicians also must engage in an endless array of one-off systems integrations. Despite a $48B investment in HIT, and meaningful use criteria requiring reporting to biosurveillance systems, most vendor electronic health records are architected monolithically, making modification difficult for hospitals and physician practices. An alternative approach is to reimagine EHRs as iPhone-like platforms supporting substitutable apps-based functionality. Substitutability is the capability inherent in a system of replacing one application with another of similar functionality.

Objective

To enable public health departments to develop “apps” to run on electronic health records (EHRs) for (1) biosurveillance and case reporting and (2) delivering alerts to the point of care. We describe a novel health information technology platform with substitutable apps constructed around core services enabling EHRs to function as iPhone-like platforms.

There has been much research on statistical methods of prospective outbreak detection that are aimed at identifying unusual clusters of one syndrome or disease, and some work on multivariate surveillance methods. In England and Wales, automated laboratory surveillance of infectious diseases has been undertaken since the early 1990’s. The statistical methodology of this automated system is described in. However, there has been little research on outbreak detection methods that are suited to large, multiple surveillance systems involving thousands of different organisms.

Objective

To look at the diversity of the patterns displayed by a range of organisms, and to seek a simple family of models that adequately describes all organisms, rather than a well-fitting model for any particular organism.

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.

 

The National Collaborative for Bio-Preparedness (NCB-Prepared) was established in 2010 to create a biosurveillance resource to enhance situational awareness and emergency preparedness. This jointinstitutional effort has drawn on expertise from the University of North Carolina- Chapel Hill, North Carolina State University, and SAS Institute, leveraging North Carolina’s role as a leader in syndromic surveillance, technology development and health data standards. As an unprecedented public/private alliance, they bring the flexibility of the private sector to support the public sector. The project has developed a functioning prototype system for multiple states that will be scaled and made more robust for national adoption.

Objective:

Demonstrate the functionality of the National Collaborative for Bio-Preparedness system.

 

EEBS’s that use near real-time information from the Internet are an increasingly important source of intelligence for public health organizations. However, there has not been a systematic assessment of EEBS evaluations, which could identify uncertainties about current systems and guide EEBS development to effectively exploit digital information for surveillance.

Objective

To assess evaluations of electronic event-based biosurveillance systems (EEBS’s) and define priorities for EEBS evaluations.