Surveillance Systems

During 2007 - 2010 the Center for Health service Management (CHSM) conducted training and consultations to strengthen the Maternal, Neonatal & Child Health (MNCH) Surveillance-Response (S-R) Systems of 10 districts and 5 municipalities of 5 provinces in Indonesia (Bali, Sulawesi Tengah, Bengkulu, Riau, and Yogyakarta). These districts and municipalities represent a mix of high and low Fiscal Capacity of the local governments and high & low Economic Capacity of the population. MNCH S-R Systems strengthening was carried out by means of two 2-day training sessions (of approximately one year apart) at the District/Municipal Health Offices (D/M HOs) and consultations via electronic telecommunication. The subject matter of the training sessions courses and consultations consisted of: (1) controlling MNCH priority diseases; (2) applying S-R core and support functions by the D/M HO and health service providers; (3) managing a S-R Support Unit at the D/M HO; and, (4) setting up a D/M HO internet web-site and publishing S-R electronic bulletins.

Objective 

To evaluate the efficacy of the MNCH S-R Systems strengthening approach used by the CHSM, Gadjah Mada University School of Medicine.

Domains go through phases of existence, and the electronic disease surveillance domain is no different. This domain has gone from an experimental phase, where initial prototyping and research tried to define what was possible, to a utility phase where the focus was on determining what tools and data were solving problems for users, to an integration phase where disparate systems that solve individual problems are tied together to solve larger, more complex problems or solve existing problems more efficiently. With the integration phase comes the desire to standardize on many aspects of the problem across these tools, data sets, and organizations. This desire to standardize is based on the assumption that if all parties are using similar language or technology then it will be easier for users and developers to move them from one place to another.

Normally the challenge to the domain is deciding on a vocabulary or technology that allows seamless transitions between all involved. The disease surveillance domain has accomplished this by trying to use some existing standards, such as HL7, and trying to develop some of their own, such as chief complaint-based syndrome definitions. However, the standards that are commonly discussed in this domain are easily misunderstood. These misunderstandings are predominantly a communication and/or educational issue, but they do cause problems in the disease surveillance domain. With the increased use of these standards due to meaningful use initiatives, these problems will continue to grow and be repeated without improved understanding and better communication about standards.

Objective

This talk will point out the inconsistencies and misunderstandings of the word "standard". Specifically, it will discuss HL7, syndrome definitions, analytical algorithms, and disease surveillance systems.

Mobile technology provides opportunities to monitor and improve health in areas of the world where resources are scarce. Poor infrastructure and the lack of access to medical services for millions have led to increased usage of mobile technology for health related purposes in recent years. As adoption has increased, so has its acceptance as a viable technology for health data collection. The ability to provide timely, accurate, and informed responses to emerging outbreaks of disease and other health threats makes mobile technology highly suitable for use in surveillance data collection activities and within the arena of global health informatics overall. The American Public Health Association defines global health informatics as the application of information and communication technologies to improve health in low-resource settings, which include the following: linking disparate sources of data together through natural language processing, use of mobile health technologies for disease surveillance, use of telemedicine to manage chronic disease, use of digital libraries to increase knowledge and awareness of public health events. 

Objective 

To present the prevailing global public health informatics landscape in developing countries highlighting current mobile system requirements and usage for disease surveillance and revealing gaps in the technology.

In development for over fourteen years, ESSENCE is a disease surveillance system utilized by public health stakeholders at city, county, state, regional, national, and global levels. The system was developed by a team from the Johns Hopkins University Applied Physics Laboratory (JHU/APL) with substantial collaborations with the US Department of Defense Global Emerging Infections Surveillance and Response System (DoD GEIS), US Department of Veterans Affairs (VA), and numerous public health departments. This team encompassed a broad range of individuals with backgrounds in epidemiology, mathematics, computer science, statistics, engineering and medicine with significant and constant influence from many public health collaborators.

Objective

This talk will describe the history and events that influenced the design and architecture decisions of the Electronic Surveillance System for Community-based Epidemics (ESSENCE)(1). Additionally, it will discuss the current functionality and capabilities of ESSENCE and the future goals and planned enhancements of the system.

In July 2006, an important heat wave occurred in France, and generated alarm of all the public health services. In Gironde, a department in region Aquitaine, the level of "warning and actions" of the Heat Health Watch Warning System, based on an analysis of weather-mortality relationship, was activated from the 16th and the 27th of July, when the limits of biometeorological indicators were reached [1].

Objective

To assess health impact of heat wave occurred in July 2006 through data from emergency activity and mortality from syndromic surveillance systems in Gironde, a department in south-western France.