Evaluation

Cardiothoracic surgery quality improvement is a core value of healthcare provision. In order to improve quality of care, information on key indicators needs to be systematically collected and maintained.In 2006, thecardiothoracic department at AgaKhan University developed an infrastructure that would enable us to answer the more challenging research queries in cardiac surgery practice. The resulting electronic cardiothoracic database is based on the European Association of Cardiothoracic Surgeons database and the Society of Thoracic Surgeons database.While, it is currently used only at Aga Khan University, it has the potential to become a multicenter database.

Objective

To assess the impact of database development and maintenance on clinical practice and quality of care.

The Washington Comprehensive Hospital Abstract Reporting System (CHARS) has collected discharge data from billing systems for every inpatient admitted to every hospital in the state since 1987 [1]. The purpose of the system is to provide data for making informed decisions on health care. The system collects age, sex, zip code and billed charges of the patient, as well as hospital names and discharge diagnoses and procedure codes. The data have potential value for monitoring the severity of outbreaks such as influenza, but not for prospective surveillance: Reporting to CHARS is manual, not real-time, and there is roughly a 9-month lag in release of information by the state. In 2005, Public Health - Seattle & King County (PHSKC) requested that hospitals report pneumonia and influenza admissions (based on both admission and discharge codes) directly to the PHSKC biosurveillance system; data elements included hospital name, date/time of admission, age, sex, home zip code, chief complaint, disposition, and diagnoses. In 2008, reporting was revised to collect separate admission and discharge diagnoses, whether the patient was intubated or was in the ICU, and a patient/visit key. Hospitals transmit data daily for visits that occurred up to 1 month earlier. Previously, we identified a strong concordance between the volume of influenza diagnoses recorded across the PHSKC and CHARS systems over time [2]. However, discrepancies were observed, particularly when stratified by hospital. We undertook an evaluation to identify the causes of these discrepancies.

Objective

We sought to evaluate the quality of influenza hospitalizations data gathered by our biosurveillance system.

The electronic surveillance system for the early notification of community-based epidemics (ESSENCE) is the web-based syndromic surveillance system utilized by DHMH. ESSENCE utilizes a secure, automated process for the transfer of data to the ESSENCE system. Data sources in the Maryland ESSENCE system include emergency department (ED) chief complaints, poison control center calls, over-the-counter (OTC) medication sales, and pharmaceutical transaction data (for certain classes of anti-bacterial and anti-viral medication). All data sources have statewide coverage and are captured daily in near real-time fashion. OIT developed a web based application in conjunction with OP&R to allow the epidemiologists involved in the ESSENCE program to monitor and audit the transfer of this data. The application allows the user to indicate whether or not each data file has been consumed into ESSENCE for any date of the year. The user can edit these daily entries at any time to update the status of the data that has been received. The user may also query the database by data source, date, and date range to generate a report. The database also contains contact information for technical and infection control staff at the hospitals that participate in the ESSENCE program. Finally, the application can also generate reports that detail which users have logged into ESSENCE, when the log-in occurred, and which pages within ESSENCE were visited.

Objective

To describe the application and process developed by the Maryland Department of Health and Mental Hygiene (DHMH) Office of Preparedness and Response (OP&R) and Office of Information Technology (OIT) for monitoring and auditing the transfer of syndromic surveillance data.

One goal of the Biological Threat Reduction Program of the US Defense Threat Reduction Agency is the enhancement of surveillance of especially dangerous pathogens of both humans and animals within countries of the former Soviet Union. One of the diseases of interest to the program is brucellosis, which is a life-threatening condition and constitutes a major health and economic challenge around the world. This is also true for Uzbekistan (UZ), where brucellosis is endemic in a number of regions. In the Samarqand region of UZ, for example, studies have reported a 9.3%, and 3.6% seroprevalence for humans and farm animals respectively.The lack of awareness about brucellosis in at-risk populations, shepherds, veterinarians and people who handle raw milk, is believed to significantly contribute to the spread of disease from animals to humans. Here we suggest mechanisms to evaluate awareness about the disease and the impact of an educational intervention in at-risk groups.

Objective

To outline the mechanism of a pilot educational brucellosis prevention program among selected high- risk groups in an endemic region of Uzbekistan.

MOH's national sentinel surveillance programme for influenza is part of the WHO international laboratory-based surveillance network to detect the emergence and spread of new antigenic variants of influenza viruses. Virological sample collection is on-going and is carried out during both outbreak and non-outbreak periods.In 2011 and 2012, the sentinel surveillance programme involved a total of 169 sites (18 government primary care clinics and 151 private/general practitioner [GP] clinics).

Objective

 We evaluated the Singapore Ministry of Health's sentinel surveillance system for influenza virus, which included the monitoring of virological samples from patients with influenza-like illness (ILI) seen at government primary care clinics and private general practitioner clinics in 2011-12.

The NYC syndromic surveillance system has been monitoring syndromes from NYC emergency department (ED) visits for over a decade. We applied several aberration detection methodologies to a time series of ED visits in NYC spiked with synthetic outbreaks. This effort is part of a larger evaluation of the NYC syndromic system, funded by a grant from the Alfred P. Sloan Foundation.

Objective

To critically evaluate temporal aberration detection methodologies using New York City (NYC) syndromic surveillance data.

Singapore's syndromic surveillance programmes include the monitoring of polyclinics and emergency departments (ED) attendances for acute diarrheal illness, acute respiratory infections, influenza-like illness, acute conjunctivitis and chickenpox.

Objective

We evaluated these syndromic surveillance systems for its representativeness, usefulness and data quality and identified areas for improvement.

Although rare in the US, the CDC reports 13-14 drinking-water-related disease outbreaks per year, affecting an average of about 1000 people. The US EPA has determined that the distribution system is the most vulnerable component of a drinking water system. Recognizing this vulnerability, water utilities are increasingly measuring disinfectant levels and other parameters in their distribution systems. The US EPA is sponsoring an initiative to fuse this distribution system water quality data with health data to improve surveillance by providing an assessment of the likelihood of the occurrence of a waterborne disease outbreak. This fused analysis capability will be available via a prototype water security module within a population-based public health syndromic surveillance system.

Objective

The objective of this paper is to illustrate a technique for combining water quality and population-based health data to monitor for water-borne disease outbreaks.

Bioterrorism surveillance is an integral component of DCHD’s Comprehensive Emergency Management Plan. This study was a collaborative effort between Duval County Health Department, University of South Florida’s Center for Biological Defense (CBD), and DataSphere, LLC. DCHD’s role in the project was to identify surveillance sites, involve community partners, share data/info with surrounding agencies, counties and the state department of health, and secure funding for the system. CBD’s role in the project was facilitating the operational and technical implementation of the system and serving as a liaison between hospitals, health departments, and DataSphere, LLC. DataSphere, LLC owns and operates BioDefend and was responsible for the technical setup and maintenance of the system. The study addressed the feasibility of automated data collection by healthcare facilities and issues related to implementation of a syndromic surveillance system.

Objective

The purpose of this study was to evaluate the implementation of the BioDefend syndromic surveillance system for its use.

Recent health events in France, such as the dramatic excess of mortality occurred during the 2003 heat wave showed the need for a better provision of information to health authorities. A new syndromic surveillance system based on the recording of general practitioner’s visits by SOS Médecins has been developed by the Aquitaine Regional Epidemiology unit (Cire).

Objective

To describe the surveillance system based on SOS Medecins data, the first GP emergency and healthcare network in France and to show the utility and validity of this data source as a real-time syndromic surveillance system.