Meaningful use and public health surveillance: to travel fast or far?

There is an ancient African proverb that states, ‘If you want to travel fast, travel alone; if you want to travel far, travel together.’ This paper examines the issue of whether public health can and should ‘go it alone’ in efforts for creating linkages between clinical care systems and the public health sector, as part of meaningful use requirements. ‘Going it alone’ in this circumstances refers to whether public health should seek to require data flows, through meaningful use requirements, that meet its work flow needs but do not add value to clinical work flows.

June 18, 2019

Impact of alternate diagnoses on the accuracy of influenza-like illness case definition used for H1N1 screening in the emergency department

In June 2009, the CDC defined a confirmed case of H1N1 as a person with an ILI and laboratory confirmed novel influenza A H1N1 virus infection. ILI is defined by the CDC as fever and cough and/or sore throat, in the absence of a known cause other than influenza. ILI cases are usually reported without accounting for alternate diagnoses (that is, pneumonia). Therefore, evaluation is needed to determine the impact of alternate diagnoses on the accuracy of the ILI case definition.


June 18, 2019

Enhanced Surveillance Improved Timeliness and Sensitivity at the FIFA 2006 World Cup in Germany

Security threats and the recent emergence of avian influenza in Europe have heightened the profile of and need for a good surveillance strategy during such events. The two main rationales for enhanced infectious disease surveillance at mass events include a perceived increased risk of infectious disease events and a need to detect and respond to events more quickly.

March 26, 2019

Using the Emergency Medical Text Processor to Standardize Chief Complaints in Boston's Syndromic Surveillance System

Abbreviation, misspellings, and site specific terminology may misclassify chief complaints syndromes. The Emergency Medical Text Processor (EMT-P) is system that cleans emergency department chief complaints and returns standard terms. However, little information is available on the implementation of EMT-P in a syndromic surveillance system.



To describe the implementation and baseline evaluation of EMT-P developed by the University of North Carolina.

July 30, 2018

Emergency Department Data Quality Best Practices

Data quality for syndromic surveillance extends beyond validating and evaluating syndrome results. Data aggregators and data providers can take additional steps to monitor and ensure the accuracy of the data. In North Carolina, hospitals are mandated to transmit electronic emergency department data to the North Carolina Disease Event Tracking and Epidemiologic Tool (NC DETECT) system at least every 24 hours.

July 30, 2018

Evaluating the Validity of ED Visit Data for Biosurveillance

The North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) receives a designated set of data elements electronically available from 110 emergency departments (EDs) (98%) on at least a daily basis via a third party data aggregator.

July 30, 2018

Multi-Sectored Approach to Evaluation of a Syndromic Surveillance System

In September 2004, Kingston, Frontenac and Lennox and Addington Public Health began a 2-year pilot project to develop and evaluate an Emergency Department Chief Complaint Syndromic Surveillance System in collaboration with the Ontario Ministry of Health and Long Term Care – Public Health Branch, Queen’s University, Public Health Agency of Canada, Kingston General Hospital and Hotel Dieu Hospital.

July 30, 2018

The Cost of Obfuscation When Reporting Locations of Cases in Syndromic Surveillance Systems

In a classical surveillance system one looks for disturbances in the number of cases, but in a spatio-temporal system, not only the number of cases observed but also where they are located is reported. What location is reported, and to which degree of accuracy it is reported are important. At one extreme les near-perfect information about each case, as with contact tracing; at the other extreme we have no information about location; viz. just that the patient exisits, or a temporal system.

July 30, 2018

Alabama Department of Public Health–Syndromic Surveillance Monitoring and Improving Data Quality

Data latency limited the Alabama Department of Public Health’s (ADPH) ability torecognize and respond quickly to public health threats. Despite ADPH’s request that 95% of syndromic surveillance (SyS) data be submitted to ESSENCE* within 24 hours of a visit, some facilities were slow to process and submit data, diminishingthe data’s usefulness for surveillance that, in turn, negated ESSENCE’s ability tofunction as a daily alert. Data could be one to several days late, depending on whether a facility was processing or sending data or was offline.

March 08, 2019


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