Health Information Systems

CDC is building a public health information grid to enable controlled distribution of data, services and applications for researchers, Federal authorities, local and state health departments nationwide, enabling efficient controlled sharing of data and analytical tools. Federated aggregate analysis of distributed data sources may detect clusters that might be invisible to smaller, isolated systems. Success of the public health grid is contingent upon the number of participating agencies and the quantity, quality, and utility of data and applications available for sharing. Grid protocols allow data owners to control data access, but requires a model to control the level of identifiability of depending upon the user’s permissions. Here, we describe a work currently in progress involving the design and implementation of an ambulatory syndromic surveillance data stream generator for the public health grid. The project is intended to broadly disseminate aggregate syndrome counts for general use by the public health community, to develop a model for sharing varying levels of identifiable data on cases depending upon the user, and to facilitate ongoing development of the grid.

Objective

To implement a syndromic surveillance system on CDC’s public health information grid, capable of securely distributing syndromic data streams ranging from aggregate case counts to individual case details, to appropriate personnel.

Zimbabwe's National Health Laboratory Services faces multiple challenges related to inadequate financial support and skilled human resources, insufficient infrastructure, and inefficient tracking of clinical samples collected by health facilities. The slow turnaround time and poor management of the sample testing process, as well as delivery of results remain critical challenges. Compounding these problems further is a manual system for tracking large volumes of samples. This laborious and time-consuming process is inefficient for management of high amounts of incoming medical samples, frequently resulting in incomplete and inaccurate data. Additionally, health facilities are unable to monitor clinical samples and results in transit, leading to misplaced samples and missing results. Furthermore, although the laboratory service runs on a tiered network system - with lower level laboratories referring surveillance samples to higher level laboratories, processing of samples is not fulfilled promptly. The solutions to these challenges are divergent - sometimes even pointing in different directions. To this end, the Zimbabwe Ministry of Health and Child Care (MoHCC) has identified and integrated a LIMS to improve tracking of samples from the time of collection through results delivery.

Objective:

Understand the challenges that exist in the Zimbabwe health systems, that could be addressed through the integration of a Laboratory Information Management System (LIMS). Understand key aspects for consideration when selecting and adapting a LIMS in a resource limited setting. Showcase improvements in laboratory information management processes following adoption of a LIMS.

Travel and tourism pose global health security risks via the introduction and spread of disease, as demonstrated by the H1N1 pandemic (2009), Chikungunya (2013), and recent Zika virus outbreak. In 2016, nearly 60 million persons visited the Caribbean. Historically no regional surveillance systems for illnesses in visitor populations existed. The Tourism and Health Information System (THiS), designed by the Caribbean Public Health Agency (CARPHA) from 2016-2017, is a new web-based application for syndromic surveillance in Caribbean accommodation settings, with real-time data analytics and aberration detection built in. Once an accommodation registers as part of the surveillance system, guests and staff can report their illness to front desk administration who then complete an online case questionnaire. Alternatively guests and staff from both registered and unregistered accommodations can self-report their illness using the online questionnaire in the THiS web application. Reported symptoms are applied against case definitions in real-time to generate the following syndromes: gastroenteritis, fever & respiratory symptoms, fever & haemorrhagic symptoms, fever & neurologic symptoms, undifferentiated fever, and fever & rash. Reported data is analyzed in real-time and displayed in a data analytic dashboard that is accessible to hotel/guest house management and surveillance officers at the Ministry of Health. Data analytics include syndrome trends over time, gender and age breakdown, and illness attack rates.

Objective:

The new Tourism and Health Information System (THiS) was implemented for syndromic surveillance in visitor accommodations in the Caribbean region. The objective was to monitor for illnesses and potential outbreaks in visitor accommodations (hotels/guest houses) in the Caribbean in real-time using the web-based application.