The purpose of this document is to define the core of PHSS practice and the minimum EHR data requirements widely used to support the core. This recommendation provides the CDC and the Office of the National Coordinator for Health Information Technology (ONC), with business requirements that will support Meaningful Use stakeholders in meeting the Stage 1 public health surveillance objective.
Syndromic Surveillance
A health information interchange architecture (HIIA) defines the attributes of a data sharing relationship between two parties. In the context of electronic syndromic surveillance (ESS), this refers to the standards, tools, and means to securely transport an ESS message from a sender (typically an Electronic Health Record, or EHR, system from a healthcare provider) to a recipient (typically a public health agency). The HIIA must support the set of business processes defined for ESS in the 2011 ISDS Final Recommendation: Core Processes and EHR Requirements for Public Health Syndromic Surveillance Report 1 and function with the available infrastructures both within public health and the larger healthcare system.
Objective
In support of national efforts to modernize and enhance health information system interoperability for public health purposes, this report seeks to clarify electronic health information interchange requirements for public health syndromic surveillance by providing: • An assessment of various health information interchange architectures for their ability to meet syndromic surveillance business requirements (See Appendix); • A comparison of potential data transport mechanisms; and • Recommendations for data transport to support Meaningful Use implementation
Syndromic surveillance information can be a useful for the early recognition of outbreaks, acute public health events and in response to natural disasters. Inhalation of particulate matter from wildland fire smoke has been linked to various acute respiratory and cardiovascular health effects. Historically, wildfire disasters occur across Southern California on a recurring basis. During 2003 and 2007, wildfires ravaged San Diego County and resulted in historic levels of population evacuation, significant impact on air quality and loss of lives and infrastructure. In 2011, the National Institutes of Health, National Institute of Environmental Health Sciences awarded Michigan Tech Research Institute a grant to address the impact of fire emissions on human health, within the context of a changing climate. San Diego County Public Health Services assisted on this project through assessment of population health impacts and provisioning of syndromic surveillance data for advanced modeling.
Objective
This presentation describes how syndromic surveillance information was combined with fire emission information and spatio-temporal fire occurrence data to evaluate, model and forecast climate change impacts on future fire scenarios.
BioSense 2.0 has become a platform for technical receipt and analysis of syndromic surveillance data for many jurisdictions nationwide, as well as a collaborative effort that has engaged a larger community of syndromic surveillance practitioners, Governance Group, and federal agencies and organizations. The potential longterm benefits of BioSense 2.0 for resource and data sharing have at times been overshadowed by the short-term limitations of the system and disconnected efforts among the CoP. In May 2014, representatives from 41 jurisdictions attended a 2-day, in-person meeting where four workgroups were formed to address on-boarding, data quality, data sharing and syndrome definition in an effort to advance changes that resonate with actual surveillance practice.
Objective
This roundtable will provide a forum for the syndromic surveillance Community of Practice (CoP) to learn about activities of the BioSense 2.0 User Group (BUG) workgroups that address priority issues in syndromic surveillance. It will be an opportunity to discuss key challenges faced by public health jurisdictions in the era of Meaningful Use and identify further needs and best practices in the areas of data quality, data sharing, onboarding, and developing syndrome definitions.
From June 4-8, 2015, the New York City (NYC) syndromic surveillance system detected five one-day citywide signals in sales of over-the-counter (OTC) antidiarrheal medications using the CUSUM method with a 56-day moving baseline. The OTC system monitors sales of two classes of antidiarrheal medications, products with loperamide or bismuth, from two NYC pharmacy chains. To determine if this increase reflected a concerning cluster of diarrheal illness, we examined multiple communicable disease surveillance data systems.
Objective
To investigate a communicable disease syndromic surveillance signal using multiple data sources.
Many syndromic surveillance systems use spatio-temporal analysis to detect local outbreaks such as gastrointestinal illnesses and lower respiratory infections. In Reunion Island, the syndromic surveillance system is based mainly on ED visits. Spatial analysis was first used in 2013 to validate retrospectively a cluster of viral meningitis. At the end of 2014, the Regional Office of French Institute for Public Health Surveillance implemented a prospective computer-automated space-time analysis in order to launch daily analyses of ED visits.
Objective
To present the implementation and the first results of a prospective spatio-temporal analysis from emergency department (ED) data in Reunion Island.
Injuries are a major but neglected global public health problem. In the low- and middle-income countries (LMIC), the problem is particularly acute due to disproportionately high incidence of injuries. Most of these injuries are preventable with appropriate interventions. Lack of complete, accurate and timely injury data is one of the main obstacle for injury prevention in LMICs. In 2001, World Health Organization (WHO) published injury surveillance guidelines emphasizing the importance of injury surveillance at country levels to cope with this grave problem. Although most of the developed countries have developed their own injury surveillance systems, there is no customizable generic injury surveillance system which can be used in LMICs. However, District Health Information System 2 (DHIS2) is a free and open source application used in many countries to collect aggregated public health data. Although it is being used for aggregated public health data it has not being used for injury surveillance.
Objective
To customize and pilot an open source public health information tool (DHIS2) for injury surveillance in a resource constrained setting, Sri Lanka.
Synthetic cannabinoids include various psychoactive chemicals that are sprayed onto plant material, which is then smoked or ingested to achieve a “high.” These products are sold under a variety of names (e.g., synthetic marijuana, spice, K2, black mamba, and crazy clown) and are sold in retail outlets as herbal products and are often labeled not for human consumption. Law enforcement agencies regulate many of these substances; however, manufacturers may frequently change the formulation and mask their intended purpose to avoid detection and regulation.
On April 6, 2015, automated surveillance algorithms via surveillance through the National Poison Data System (NPDS), a web-based surveillance system of all calls to United States (US) poison centers (PCs), identified an increase in calls to PCs related to synthetic cannabinoid use. To identify risk factors and adverse health effects, CDC analyzed all calls to PCs about synthetic cannabinoid use from January to May, 2015.
Objective
The Centers for Disease Control and Prevention analyzed all calls to poison centers about synthetic cannabinoid use from January to May 2015 to identify risk factors and adverse health effects related to this emerging public health threat.
VA began using ESSENCE as a public health surveillance tool in 2005. The system offered alerting capability for pre-defined syndromes and querying capability for outpatient ICD-9 diagnosis codes. Herein, we highlight examples of how we have invested in upgrades to analytic capabilities and expanded data sources available to ESSENCE in order to augment the overall utility of this system within VA.
Objective
To describe VA’s experience developing innovative and alternative uses of a surveillance system and improve the overall value proposition of this tool for the agency.
Since the terrorist attacks against the satirical newspaper Charlie Hebdo in January 2015, France has activated the highest level of its national anti-terrorist security plan. A new terrorist attack occurred the 26th of June at 9:50 AM in a gas production plant located in the industrial area of Saint Quentin Fallavier nearby Lyon (East -South-of France). The plant produces several different chemical products like gas and plastics and employed 40 people. The attack resulted in an explosion followed by fire. The French Institute for Public Health Surveillance (InVS) was alerted at 11 AM and decided to implement with its Rhône-Alpes regional office a protocol to timely assess the potential health impact on the population living or working around the attack area on emergency health care facilities (EHCF).
Objective
To timely assess the potential health impact on the population living or working in a terrorist attack area using syndromic surveillance
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