Informatics

Zika virus spread quickly through South and Central America in 2015. The City of Houston saw its first travel-related Zika cases in December of 2015. On January 29th, the City held the first planning meeting with regional partners from healthcare, blood banks, petrochemical companies, mosquito control, and others. Additionally the City activated Incident Command Structure (ICS) and designated the Public Health Authority as the Incident Commander.

Initial steps taken by HHD included expanding the capability and capacity of the public health laboratory to test for Zika virus; expand surveillance efforts; created an educational campaign around the “3Ds” of Zika defense (Drain, Dress, DEET) which were then disseminated through several means, including a mass mailing with water bills; and provided DEET to mothers through the WIC program.

The Houston Health Department took the lead in authoring the City’s Zika Action Plan. In this 3 goals and 6 strategies were identified. Goals included 1) Keep Houstonians and visitors aware of the threat of Zika; 2) minimize the spread of the virus; and 3) protect pregnant women from the virus. The 6 strategies employed were to A) develop preparedness plans; B) implement ICS within the City; C) ensure situational awareness through surveillance; D) Increase community awareness; E) reduce opportunities for Zika mosquito breeding grounds; and F) provide direct intervention to reduce the threat of Zika.

HHD was responsible for many of the action items within the plan. We conducted several community outreach events, where we disseminated educational materials, t-shirts, DEET, and other give- aways. These events allowed frequent engagement with the public for bidrectional communication on how to approach the threat. 

Objective

This session will explore the role of the Houston Health Department (HHD) in the City of Houston’s response to the threat of Zika. The panelists will provide perspective from the roles of Bureau Chief, informatician, and epidemiologist and provide insight into lessons learned and strategic successes. 

Healthcare data, including emergency department (ED) and outpatient health visit data, are potentially useful to the public health community for multiple purposes, including programmatic and surveillance activities. These data are collected through several mechanisms, including administrative data sources [e.g., MarketScan claims data1; American Hospital Association (AHA) data2] andpublic health surveillance programs [e.g., the National Syndromic Surveillance Program (NSSP)3]. Administrative data typically become available months to years after healthcare encounters; however, data collected through NSSP provide near real time information not otherwise available to public health. To date, 46 state and 16 local health departments participate in NSSP, and the estimated nationalp ercentage of ED visits covered by the NSSP BioSense platform is 54%. NSSP’s new data visualization tool, ESSENCE, also includes additional types of healthcare visit (e.g., urgent care) data. Although NSSP is designed to support situational awareness and emergency response, potential expanded use of data collected through NSSP (i.e., by additional public health programs) would promote the utility, value, and long-term sustainability of NSSP and enhance surveillance at the local, state, regional, and national levels. On the other hand, studies using administrative data may help public health programs better understand how NSSP data could enhance their surveillance activities. Such studies could also inform the collection and utilizationof data reported to NSSP.

Objective

This roundtable will address how multiple data sources, including administrative and syndromic surveillance data, can enhance public health surveillance activities at the local, state, regional, and national levels. Provisional findings from three studies will be presented to promote discussion about the complementary uses, strengths and limitations, and value of these data sources to address public health priorities and surveillance strategies.

Multiple agencies are involved in global disease surveillance and coordination of activities is essential to achieve broad public health impact. Multiple examples of effective and collaborative initiatives exist. The WHO/AFRO developed Integrated Disease Surveillance and Response (IDSR) framework, adopted by 43 of the 46 AFRO member states and applied in other WHO regions, was the first framework designed to strengthen national disease surveillance and response systems. The WHO International Health Regulations (IHR) 2005 are an agreement between 196 countries to prevent, detect and respond to the international spread of disease. In 2013 CDC worked with Uganda and Vietnam to demonstrate the development of surveillance, laboratory, and emergency response center capacity and link data systems for six outbreak prone diseases. More recently, the Global Health Security Agenda (GHSA) was launched with the support of 28 countries, WHO, OIE and FAO just as Ebola was beginning to emerge in West Africa. This panel brings together CDC, local implementing partners, academic technical partners, and international non-government donor to discuss current and evolving strategies for prevention, detection, and response activities needed for global health security. 

Objective

The session will discuss strategies for outbreak prevention, detection, and response for global health security and explore how these activities inform both domestic and international initiatives. Innovations in epidemiology, laboratory, informatics, investment, and coordination for disease surveillance will be discussed. 

The Minnesota Department of Health (MDH) needs to be able to collect, use, and share clinical, individual-level health data electronically in secure and standardized ways in order to optimize surveillance capabilities, support public health goals, and ensure proper follow-up and action to public health threats. MDH programs, public health departments, and health care providers across the state are facing increasing demands to receive and submit electronic health data through approaches that are secure, coordinated, and efficient; use appropriate data standards; meet state and federal privacy laws; and align with best practices. This framework builds upon existing informatics models and two past studies assessing health information exchange (HIE) conducted by the MDH Office of Health Information Technology (OHIT) to provide MDH surveillance systems with an outline of the key elements and considerations for transitioning to more secure, standards-based, electronic data exchange. 

Objective

To create an informatics framework and provide guidance to help Minnesota’s public health surveillance systems achieve interoperability and transition to standards-based electronic information exchange with external health care providers using the state’s birth defects registry as an initial pilot program. 

Link to publication: 

View the abstract here

The purpose of this project is to demonstrate progress in developing a scientific and practical approach for public health (PH) emergency preparedness and response informatics (EPRI) that supports the National Health Security Strategy and Global Health Security Agenda (GHSA) objectives. PH emergency operations centers (EOC) contribute to health security objectives because they operationalize response, recovery and mitigation activities during national and international PH events. The primary focus of this presentation is to describe the results of an analysis of CDC’s EOC, and other EOCs, in building their EPRI capabilities. 

RTI International has worked on enhancing health information and disease surveillance systems in many countries, including The Democratic Republic of the Congo (DRC), Guinea, Indonesia, Kenya, Nepal, Philippines, Tanzania, Zambia, and Zimbabwe. Strengthening these systems is critical for all three of the Prevent, Detect and Respond domains within the Global Health Security Agenda. 

We have deep experience in this area, ranging from implementing District Health Information Software (DHIS), electronic medical records, health facility registries, eHealth national strategies, electronic Integrated Disease Surveillance and Response system (eIDSR), mobile real-time malaria surveillance and response, national weekly disease surveillance, patient referral system, and community based surveillance. These experiences and lessons learned can inform work being done to advance the GHSA.

We will discuss several examples, including activities in Zimbabwe and Tanzania. RTI has been working in Zimbabwe for over six years to strengthen the national health information system. This work has included the configuration and roll-out of DHIS 2, the national electronic health information system. In doing so, RTI examined and revitalized the weekly disease surveillance system, improving disease reporting timeliness and completeness from 40% to 90%. Additionally, RTI has integrated mobile technology to help more rapidly communicate laboratory test results, a laboratory information management systems to manage and guide test sample processing, and various other patient level systems in support of health service delivery at the local level. This work has involved capacity building within the ministry of health to allow for sustainable support of health information systems practices and technology and improvements to data dissemination and use practices. 

Objective

The objective is to discuss two decades of international experience in health information and disease surveillance systems strengthening and synthesize lessons learned as applicable to implementation of the Global Health Security Agenda (GHSA).