Emergency Department (ED)

Assessing health disparities and access to healthcare has been an important issue for emergency preparedness and response efforts in the Denver metropolitan area. There have been several high profile MJ-related illness outbreaks in the US over the past 2 years. The legalization and retail sale of recreational MJ in Colorado necessitates enhanced surveillance for adverse effects from MJ use. TCHD and DPH coordinated to use syndromic surveillance data to provide situational awareness and timely outbreak detection related to MJ, including health disparities and overall impacts on population health.

Objective

Adverse health effects related to marijuana (MJ) use may disproportionately impact populations based on age or gender. To explore whether disparities exist among persons seeking emergency department (ED) care related to MJ use, Tri-County Health Department (TCHD) and Denver Public Health (DPH) developed MJ use case definitions, described patient demographics, mapped patients’ geographic distribution relative to marijuana dispensary locations, evaluated access to healthcare, and investigated the potential impact of MJ on pediatric health.

Community health assessments are a foundation of public health practice and a prerequisite to achieving public health accreditation. Best practice dictates that CHAs must incorporate qualitative and quantitative data and utilize a number of indicators to create a detailed picture of a community’s health. Metrics may describe demographics, social and economic factors, health behaviors, health outcomes, and healthcare access and utilization. Commonly used indicators facilitate cross-jurisdiction comparisons and simplify decisionmaking. However, while many readily available indicators exist on a county level, few have been made available on the sub-county level. Syndromic surveillance messages, typically emergency room visit records, contain sub-county level data on patient residence, such as zip code or municipality. As hospitals progress towards meeting Stage 2 Meaningful Use requirements, transmission of syndromic surveillance data to public health entities will become standard. Analysis of emergency room visit data, either in aggregate or by specific syndromes, may be a valuable sub-county level indicator of community health status and access to care that can be standardized across jurisdictions.

Objective

To identify geographic clustering of elevated emergency room (ER) usage rates for incorporation into community health assessments (CHA) in suburban Cook County and to validate this metric as a potential sub-county level community health indicator.

Today, Internet, especially Wikipedia, is an important part of everyday life. People can notably use this popular free online encyclopedia to search health-related information. Recent studies showed that Wikipedia data can be used to monitor and to forecast influenza-like illnesses in near real time in the United States [1,2].

 We carried out a study to explore whether French Wikipedia data allow to monitor the trends of five seasonal diseases in metropolitan France: influenza-like illness, gastroenteritis, bronchiolitis, chickenpox and asthma.

Objective

To explore the interest of Wikipedia as a data source to monitor seasonal diseases trends in metropolitan France.

Recreational drug use is a major problem in the United States and around the world. Specifically, drug abuse results in heavy use of emergency department (ED) services, and is a high financial burden to society and to the hospitals due to chronic ill health and multiple injection drug use complications. Intravenous drug users are at high risk of developing sepsis and endocarditis due to the use of a dirty or infected needle that is either shared with someone else or re-used. It can also occur when a drug user repeatedly injects into an inflamed and infected site or due to the poor overall health of an injection drug user. The average cost of hospitalization for aortic valve replacement in USA is about $165,000, and in order for the valve replacement to be successful, patients must abstain from using drugs.

Objective

To describe how the state syndromic surveillance system (NC DETECT) was used to initiate near real time surveillance for endocarditis, sepsis and skin infection among drug users.

The North Dakota Department of Health (NDDoH) investigated the feasibility of using syndromic surveillance (SyS) data to identify health care visits due to electronic cigarette (e-cigarette) use. E-cigarettes have been associated with injuries and fatalities in all age groups, including young children attracted to the colorful liquid nicotine carriage packaging [1]. Previously, poison control data was the only resource available to the NDDoH for e-cigarette adverse outcomes surveillance.

Objective

To explore the use of emergency department syndromic surveillance data to identify adverse health events related to electronic cigarettes in order in enhance existing surveillance.

Violence is now clearly recognized as a public health problem. Intentional injuries ranked among the top six leading causes of death for Illinois residents aged 1-44 in 2013. The Illinois Department of Public Health currently collects data on violent injuries and deaths from emergency medical services reports, death certificates, coroner/ medical examiner reports, law enforcement reports, and crime lab reports. However, syndromic surveillance provides near real-time data on violence-related emergency department visits that would increase the timeliness and quality of data available for public health interventions.

Objective

Our objective was to measure the incidence and prevalence of intentional violent injury and death using Illinois’ syndromic surveillance system.

In New Jersey, real-time emergency department (ED) data are currently received from EDs by Health Monitoring Systems Inc.’s (HMS) EpiCenter, which collects, manages and analyzes ED registration data for syndromic surveillance, and provides alerts to state and local health departments for surveillance anomalies.

EpiCenter receives pre-diagnostic chief complaint data from 78 of 80 acute care and satellite EDs. The need for more specific information raises the possibility that other data elements from EDs such as triage notes can be of utility in detecting outbreaks without a significant delay. This study evaluates the inclusion of triage notes in EpiCenter to detect a recent increased usage of synthetic cannabinoids. At the time of this evaluation, three New Jersey hospitals were providing triage notes in their EpiCenter data.

Objective

Describe the inclusion of triage notes into a syndromic surveillance system to enhance population health surveillance activities.

Public health in Ontario, Canada has no standardized system for carrying out syndromic surveillance. Previous research had demonstrated wide variation in the implementation of syndromic surveillance.

Objective:

To describe results of a prospective study to assess the impact of using a standard process by which public health units (PHUs) investigate syndromic surveillance alerts for respiratory illness.