Planning

Information and Communication Technology (ICT) can enhance public health surveillance (PHS) by facilitating the digital exchange of information. Electronic surveillance (e-Surveillance) is the use of electronic systems to empower the digitization of PHS functions of prevention, detection, and response. E-Surveillance maximizes compliance with the International Health Regulations (2005), enables efficient Integrated Disease Surveillance and Response, and empowers One Health.

In Africa, e-Health is hindered by donor-funded, short-term projects known as “pilotitus.” Proactive national leadership is required to establish a sustainable e-Surveillance program; an assessment and a strategic plan are the first steps.

Therefore, the One Health e-Surveillance Initiative (OHSI) was conceived and piloted by Public Health Practice, LLC (PHP) and the African Field Epidemiology Network (AFENET), with support by the Defense Threat Reduction Agency and the U.S. Centers for Disease Control and Prevention (CDC).

Objective

1) To establish One Health workgroups and conduct an e-Surveillance assessment to inform national strategic planning efforts in pilot countries. 2) To provide evidence for the African Surveillance Informatics Governance Board (ASIGB) to address its mission of establishing e-Surveillance.

In South Korea, the NNDSS is organized at three levels: local, provincial, and central. At the local level, physicians report the cased to the Public Health Center (PHC) and PHC conduct control measures. At the provincial level, the PHC reports the cases to the Department of Health (DOH) of the province and DOH obliged to report the cases to the Korea Centers for Disease Control and Prevention (KCDC) and feedback of the surveillance data to PHC and physicians. At the central level, the Disease Web Statistics System (http://is.cdc.go.kr/ dstat/index.jsp) provides real-time data on 54 national notifiable infectious diseases.

Although there are variations according to the disease and surveillance step, the KNNDSS generally functions well in terms of timeliness and Yu et al. reported that 89.7% of mumps, one of the most incident contagious disease in South Korea, reported in 15 days after the physician’s notification. To improve the timeliness of feedback at the provincial level, we explored the KNNDSS data and suggested an evidence based duration for publication of the weekly reports, in consideration of reducing the publication schedule.

Objective

This study will explore the timeliness of the Korean National Notifiable Disease Surveillance System (KNNDSS) at provincial Level, and suggest a reasonable duration for publication the weekly reports to improve timely feedback of infectious disease surveillance data to physicians and community.

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.

Evaluation and strengthening of biosurveillance systems is acomplex process that involves sequential decision steps, numerous stakeholders, and requires accommodating multiple and conflicting objectives. Biosurveillance evaluation, the initiating step towards biosurveillance strengthening, is a multi-dimensional decision problem that can be properly addressed via multi-criteria-decision models.Existing evaluation frameworks tend to focus on “hard” technical attributes (e.g. sensitivity) while ignoring other “soft” criteria (e.g. transparency) of difficult measurement and aggregation. As a result, biosurveillance value, a multi-dimensional entity, is not properly defined or assessed. Not addressing the entire range of criteria leads to partial evaluations that may fail to convene sufficient support across the stakeholders’ base for biosurveillance improvements.We seek to develop a generic and flexible evaluation framework capable of integrating the multiple and conflicting criteria and values of different stakeholders, and which is sufficiently tractable to allow quantification of the value of specific biosurveillance projects towards the overall performance of biosurveillance systems.

Objective

To describe the development of an evaluation framework that allows quantification of surveillance functions and subsequent aggregation towards an overall score for biosurveillance system performance.