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Syndromic Surveillance

Description

In July 2016, 77% of ED data was transmitted daily via Health Level 7 (HL7) messages, compared to only 27% in July 2015 (Figure). During this same period, chief complaint (CC) word count has increased from an average of 3.8 words to 6.0 words, with a twenty-fold increase in the appearance of the word “denies” in the chief complaint (Figure). While HL7 messages provide robust chief complaint data, this may also introduce errors that could lead to symptom and syndrome misclassification. 

Objective

To describe the effect of symptom negation in emergency department (ED) chief complaint data received by the New York City (NYC) Department of Health and Mental Hygiene (DOHMH), and to devise a solution to avoid syndrome and symptom misclassification for commonly used negations using SAS Perl Regular Expression (PRX) functions. 

Submitted by Magou on
Description

Hurricane ‘Superstorm’ Sandy struck New Jersey on October 29, 2012, causing harm to the health of New Jersey residents and billions of dollars of damage to businesses, transportation, and infrastructure. Monitoring health outcomes for increased illness and injury due to a severe weather event is important in measuring the severity of conditions and the efficacy of state response, as well as in emergency response preparations for future severe weather events. Following the experience with Hurricane Sandy, NJDOH initiated a project to develop a suite of 19 indicators, known as the Severe Weather Classifier (SWC) in EpiCenter, an online system which collects emergency department chief complaint data in real-time, to perform syndromic surveillance of extreme weather–related conditions. NJDOH has since used these classifiers in more recent events to monitor for weather-related visits to storm-affected area emergency departments (ED’s).

In June, 2015, a squall line of damaging thunderstorms, known as a “bow echo,” caused downed wires and multi-day power outages in Camden and Gloucester counties in southern New Jersey. Almost exactly seven months later, in January, 2016, Winter Storm Jonas dropped more than a foot of snow over New Jersey. These events provided an opportunity to assess the indicators within SWC. 

Objective

To report the results of the application of New Jersey’s Severe Weather Classifier in New Jersey’s syndromic surveillance system during two extreme weather events. 

Submitted by Magou on
Description

Overdoses of heroin and prescription opioids are a growing cause of mortality in the United States. Deaths from opioids have contributed to a rise in the overall mortality rate of middle-aged white males during an era when other demographics are experiencing life expectancy gains. A successful public health intervention to reverse this mortality trend requires a detailed understanding of which populations are most affected and where those populations live. While mortality is the most relevant metric for this emerging challenge, increased burden on laboratory facilities can create significant delays in obtaining confirmation of which patients died from opioid overdoses.

Emergency department visits for opioid overdoses can provide a more timely proxy measure of overall opioid use. Unfortunately, chief complaints do not always contain an indication of opioid involvement. Overdose patients are not always conscious at registration which limits the amount of information they can provide. Menu-driven registration systems can lump all overdoses together regardless of substance. A more complete record of the emergency department interaction, such as that provided by triage notes, could provide the information necessary to differentiate opioid-related visits from other overdoses. 

Objective

To identify heroin- and opioid-related emergency department visits using pre-diagnositc data. To demonstrate the value of clinical notes to public health surveillance and situational awareness. 

 

Submitted by Magou on

Adverse health effects related to climate change are currently being seen, and these adverse outcomes are likely to increase in the future. Syndromic surveillance systems can provide near-real time information which may be used for situational awareness as communities react to these adverse events. These systems may also provide another source of retrospective information, such as triage notes or diagnostic data at time of visit (e.g. blood pressure), which can also be used for planning and response.

Description

In September, 2015, Nigeria was delisted from the list of polio endemic countries globally. To be certified polio free, the country must attain and maintain certification standard Acute Flaccid Paralysis(AFP) surveillance for additional two-years. In Oyo State, no case of Wild Polio Virus (WPV) has been reported since February, 2009.

Objective

We evaluated the AFP surveillance system in Oyo State to assessits attributes and determine if it was meeting its set objectives.

Submitted by teresa.hamby@d… on
Description

Public health surveillance largely relies on the use of surveillance systems to facilitate the identification and investigation of epidemiologic concerns reflected in data. In order to support public health response, these systems must present relevant information, and be user-friendly, dynamic, and easily-implementable. The abundance of R tools freely-available online for data analysis and visualization presents not only opportunities but also challenges for adoption in that these tools must be integrated so as to allow a structured workflow. Many public health surveillance practitioners do not have the time available to 1) scavenge for tools, 2) align their functions so as to create a relevant set of visuals, and 3) integrate these visuals into a dashboard that allows a streamlined surveillance workflow. An openly-available, structured framework that allows simple integration of analytic capabilities packaged into readily- implementable modules would simplify the creation of relevant dashboard visuals by surveillance practitioners. 

Objective

A framework and toolbox for creating point-and-click dashboard applications (at no cost) for monitoring several facets of syndromic surveillance data were created. These tools (and associated documentation) are being made available freely online for other surveillance practitioners to adopt. 

Submitted by Magou on

In this webinar, the syndromic surveillance service delivered by Public Health England will be discussed. The presentation will describe the national syndromic surveillance systems used in England (general practitioners, emergency departments, telehealth call services), the routine statistical and analytical methods used to process the data, the 'service' delivered by the team and future data sources under consideration.

Description

To describe the results of the new organization of influenza surveillance in France, based on a regional approach. This regional multi-source approach has been made possible by the sharing of data visualizations and statistical results through a web application. This application helped detecting early the epidemic start and allowed a reactive communication with the regional health authorities in charge of the organization of health care, the management and the setting up of the appropriate preventive measures.

Submitted by aising on

Abstract

OBJECTIVES:

Reliable methods are needed to monitor the public health impact of changing laws and perceptions about marijuana. Structured and free-text emergency department (ED) visit data offer an opportunity to monitor the impact of these changes in near-real time. Our objectives were to (1) generate and validate a syndromic case definition for ED visits potentially related to marijuana and (2) describe a method for doing so that was less resource intensive than traditional methods.

Submitted by ctong on
Description

The Syndromic Surveillance Consortium of Southeast Texas (SSCSeT) consists of 13 stakeholders who represent 19 counties or jurisdictions in the Texas Gulf Coast region and receives health data from over 100 providers. The Houston Health Department (HHD) maintains and operates the syndromic surveillance system for the Gulf Coast region since 2007. In preparation for Meaningful Use (MU) the HHD has adapted and implemented guidance and recommendations from Centers for Disease Control and Prevention, Office of National Coordinator for Health Information Technology and others. HHDs goal is to make it possible for providers meet MU specification by facilitating the transmission of health related data for syndromic surveillance. The timing of the transition into MU overlaps with the change in syndromic surveillance systems. 

Presenters

Eunice R. Santos, Wesley McNeely, Biru Yang and Raouf R. Arafat - Office of Surveillance and Public Health Preparedness, Houston Health Department, Houston, TX, USA 

Submitted by uysz on