Standards

The American Health Information Community Harmonized Use Case for the Biosurveillance minimum data set (MDS) was implemented to establish data exchange between regional health information organizations (RHIOs) and the New York State Department of Health (NYSDOH) for accelerating situational awareness through the Health Information Exchange (HIE) Project. However, the completeness, timeliness of the reporting and quality of data elements in the MDS through RHIOs are still unknown and need further validation before we can utilize them for NYSDOH public health surveillance.

Objective

Evaluate the availability, timeliness, and accuracy of MDS data elements received from one RHIO for emergency department (ED), in-patient, and outpatient visits. Compare the characteristics of patients meeting the HIE influenza-like illness definition who were admitted to the hospital or expired versus those discharged home.

The EPA Water Security initiative contamination warning system detection strategy involves the use of multiple monitoring and surveillance components for timely detection of drinking water contamination in the distribution system. The public health surveillance (PHS) component of the contamination warning system involves the analysis of health-related data to identify disease events that may stem from drinking water contamination. Public health data include hospital admission reports, infectious disease surveillance, emergency medical service reports, 911 calls and poison control center calls. Automated analysis of these data streams results in alerts, which are investigated by health department epidemiologists. A comprehensive operational strategy was developed to describe the processes and procedures involved in the the initial investigation and validation of a PHS alert. The operational strategy established specific roles and responsibilities, and detailed procedural flow descriptions. The procedural flow concluded with the determination of whether or not an alert generated from surveillance of public health data streams is indicative of a possible water contamination incident.

Objective

To develop standard operating procedures to identify or rule out possible water contamination as a cause for a syndromic surveillance alarm.

The Distribute project began in 2006 as a distributed, syndromic surveillance demonstration project that networked state and local health departments to share aggregate emergency department-based influenza-like illness (ILI) syndrome data. Preliminary work found that local systems often applied syndrome definitions specific to their regions; these definitions were sometimes trusted and understood better than standardized ones because they allowed for regional variations in idiom and coding and were tailored by departments for their own surveillance needs. Originally, sites were asked to send whatever syndrome definition they had found most useful for monitoring ILI. Places using multiple definitions were asked to send their broader, higher count syndrome. In 2008, sites were asked to send both a broad syndrome, and a narrow syndrome specific to ILI.

Objective

To describe the initial phase of the ISDS Distribute project ILI syndrome standardization pilot.

The detailed analysis of the epidemiological literature on the 2003 SARS epidemic published in peer reviewed journals has shown that a majority (78%) of the epidemiological articles were submitted after the epidemic had ended, although the

corresponding studies had relevance to public health authorities during the epidemic. The conclusion was that to minimize the lag between research and the exigency of public health practice in the future, researchers should consider adopting common, predefined protocols and ready-to-use instruments to improve timeliness, and thus, relevance, in addition to standardizing comparability across studies.

Objective

This paper describes how the ideas and tools of e-commerce can be translated to the investigation of outbreaks: epidemiologists will ‘shop’ the best available items for their

questionnaire, enhance the chances of producing interoperable questionnaires, and speed up the whole process.

Utah Statewide Immunization Information System (USIIS) is the state immunization registry. It is connected to about 700 organizations, including 100% public health clinics, 60% of private providers, many schools, daycares, pharmacies, and Indian Health Services. Data exchange methods range from web data entry, batch file transfer, proprietary or HL7 data interfaces, and real-time exchange with Intermountain

Healthcare’s electronic health records. Clinicians in Utah ranked immunization data as one of the first five use cases for developing the statewide clinical Health Information Exchange (cHIE) in Utah Health Information Network. Utah Department of Health has collaborated with Utah Health Information Network to develop the immunization information exchange.

Objective

The goal of the immunization information exchange is to expand the USIIS interoperability to all private providers, especially those who are not a USIIS’ user but participate in cHIE.

Ontologies representing knowledge from the public health and surveillance domains currently exist. However, they focus on infectious diseases (infectious disease ontology), reportable diseases (PHSkbFretired) and internet surveillance from news text (BioCaster ontology), or are commercial products (OntoReason public health ontology). From the perspective of biosurveillance text mining, these ontologies do not adequately represent the kind of knowledge found in clinical reports. Our project aims to fill this gap by developing a stand-alone ontology for the public health/biosurveillance domain, which (1) provides a starting point for standard development, (2) is straightforward for public health professionals to use for text analysis, and (3) can be easily plugged into existing syndromic surveillance systems.

Objective

To develop an application ontology - the extended syndromic surveillance ontology - to support text mining of ER and radiology reports for public health surveillance. The ontology encodes syndromes, diagnoses, symptoms, signs and radiology results relevant to syndromic surveillance (with a special focus on bioterrorism).

State laws mandate clinicians and laboratories to report occurrences of reportable diseases to public health entities. For this purpose, a set of case-reporting specifications are published and maintained by public health departments. There are several problems with the existing case-reporting specifications: (1) they are described on individual state websites and posters and not structured or executable; (2) the specifications are often misleading representing case classification rather than case reporting criteria; (3) they vary across jurisdictions and change over time; and (4) reporting facilities are required to interpret the criteria and maintain logic in their own systems. To overcome these problems, we are designing and developing a prototype system to represent case-reporting specifications that can be authored and maintained by public health and published openly.

Objective

In this paper, we describe the content and functional requirements for a knowledge management system that can be authored by public health authorities to inform reporting facilities ‘what’s reportable where’.