Stakeholder Engagement

Although the advent of the ONCs "meaningful use" criteria has added significant new incentives for healthcare organizations to provide the necessary data for implementing syndromic surveillance, incentives alone are not sufficient to sustain a robust community of practice that engages public health and healthcare practitioners working together to fully achieve meaningful use objectives. The process for building a successful community of practice around syndromic surveillance is primarily application-agnostic. The business process has many of the same characteristics regardless of application features, and can be incrementally customized for each community based on the unique needs and opportunities and the functional characteristics of the application. This presentation will explore lessons-learned in the north central Texas region with BioSense 1 and ESSENCE over the past six years, and will describe the multi-phase process currently underway for BioSense 2.0. Key program process steps and success criteria for public health and healthcare practitioners will be described. This road map will enable other local health department jurisdictions to replicate proven methodologies in their own communities. The presentation will also highlight what it takes for an existing community of practice with a home grown system to move processes and protocols to the cloud.

Objective

To explore the lessons learned from the Advanced Practice Center methodology regarding the implementation of syndromic surveillance while considering what it takes to create, enhance, and sustain relationships between hospitals, public health practitioners, and the community.

The Oregon Health Authority (OHA), in collaboration with the Johns Hopkins University Applied Physics Laboratory, implemented a syndromic surveillance system, Oregon ESSENCE. A critical component to developing and growing this statewide system is obtaining buy-in and voluntary participation from hospital Emergency Departments (EDs). This process involves approval at multiple levels within a hospital facility from administration to information technology staff responsible for sending electronic ED data to the Oregon ESSENCE system. Therefore, developing marketing materials that appeal to a wide range of recruitment audiences is a key step in obtaining stakeholder buy-in. OHA adopted the ISDS and CDC syndromic surveillance standards for the public health objective of the Center for Medicaid and Medicare Services (CMS) Meaningful Use Programs. However, Oregon hospitals will not receive financial incentive to participate in Oregon ESSENCE from CMS until 2014 during stage two of Meaningful Use. Consequently, this project's early years will focus on obtaining voluntary participation from hospitals.

Objective

Encourage hospitals to participate in OHA emergency department syndromic surveillance system, Oregon ESSENCE.

In the summer of 2001, New Jersey (NJ) was in the process of developing surveillance activities for bioterrorism. On September 11, 2001, the U.S. suffered a major terrorist attack. Approximately a month later, Anthrax-laced letters were processed through a New Jersey Postal Distribution Center (PDC). As a result of these events, the state instituted simplistic surveillance activities in emergency departments (ED's). Over time, this initial system has developed into a broader, more streamlined approach to surveillance that now includes syndromic data e.g., Influenza-like illness (ILI) as well as the use of technology (automated surveys, real-time data connections, and alert analysis) to achieve surveillance goals and provide daily information to public health partners in local health departments and DHSS response colleagues.

Objective

To describe the improvements in New Jersey's Emergency Department surveillance system over time.

In 2003, the need for a system to track and manage patient status and location was identified by Boston Emergency Medical Services (Boston EMS) and the Conference of Boston Teaching Hospitals. After consultation with EMS (municipal, fire based, and private), hospital, local and state public health and emergency management stakeholders, a core group from Boston EMS and Boston Public Health Commission (BPHC) developed guidelines for a Metro Boston Patient Tracking System. The goal was to provide a system to reunite family members and serve as a tool for managing short term/high impact mass casualty incidents and protracted disease outbreaks.

Since 2004, BPHC Communicable Disease Control Division (CDC) has effectively managed several mass prophylaxis clinics in response to infectious disease outbreaks. However patient data was largely collected on paper based forms, limiting the availability of real-time clinic data to incident command. To address these challenges BPHC CDC began meeting with Boston EMS to define the business processes and information needs during public health emergencies.

Objective

To describe the electronic patient tracking system configured by Boston EMS and the BPHC CDC to address information needs during public health emergencies.

The former Soviet Union (FSU)—through the Sanitary-Epidemiologic Service (SES)—developed an extensive system of disease surveillance that was effective, yet centrally planned in Moscow. Even after the fall of the FSU in 1991, most newly independent states maintained all or parts of the SES structure. However, even 15 years later, the loss of economic and technical assistance from Moscow has negatively impacted the effectiveness and efficiency of disease surveillance in these republics, including Armenia and Georgia. In 2005, Armenia and Georgia reported tuberculosis (TB) incidences of 71 and 83, respectively, per 100,000.

Objective

To enhance its effectiveness and efficiency, we evaluated TB surveillance in the FSU Republics of Armenia and Georgia.

For more than a decade, biosurveillance systems (and more recently BioSense) have been employed in the United States. Efforts to drastically expand these surveillance capacities have been a national priority given concerns about national security. However, there has been little emphasis on value or increasing value to communities or agencies contributing and analyzing data. This qualitative analysis focused on all biosurveillance stakeholders and the opportunity to enhance interoperability and reuse of data and systems.

Objective

To understand the perspective of biosurveillance stakeholders and how their participation creates value for them as well as public health departments.