How Missing Discharge Diagnosis Data in Syndromic Surveillance Leads to Coverage Gaps

Indiana utilizes the Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE) to collect and analyze data from participating hospital emergency departments. This real-time collection of health related data is used to identify disease clusters and unusual disease occurrences. By Administrative Code, the Indiana State Department of Health (ISDH) requires electronic submission of chief complaints from patient visits to EDs. Submission of discharge diagnosis is not required by Indiana Administrative Code, leaving coverage gaps.

January 25, 2018

Using Syndromic Data for Opioid Overdose Surveillance in Utah

The current surveillance system for opioid-related overdoses at UDOH has been limited to mortality data provided by the Office of the Medical Examiner (OME). Timeliness is a major concern with OME data due to the considerable lag in its availability, often up to six months or more. To enhance opioid overdose surveillance, UDOH has implemented additional surveillance using timely syndromic data to monitor fatal and nonfatal opioid-related overdoses in Utah.

Objective:

January 21, 2018

A pilot project to identify individuals who died from suicide and visited an ED before death

In 2015, suicide was the 8th leading cause of death in Salt Lake County, Utah, and has recently been identified as a priority public health issue. For suicide, suicide ideation and suicide attempts surveillance, Salt Lake County Health Department staff use National Violent Death Reporting System (NVDRS) mortality data to monitor historical trends and vital records mortality data and ESSENCE ED encounter morbidity data to monitor trends and populations in real time.

January 25, 2018

Assessing Prior Pain Visits and Medical History Risk Factors for Opioid Overdose

Opioid overdoses are a growing cause of mortality in the United States. Medical prescriptions for opioids are a risk factor for overdose. This observation raises concerns that patients may seek multiple opioid prescriptions, possibly increasing their overdose risk. One route for obtaining those prescriptions is visiting the emergency department (ED) for pain-related complaints. Here, two hypotheses related to prescription seeking and overdoses are tested. (1) Overdose patients have a larger number of prior ED visits than matched controls.

January 21, 2018

Improving Syndromic Data Quality through Implementation of Error Capture Module

Oregon Public Health Division (OPHD), in collaboration with The Johns Hopkins University Applied Physics Laboratory, implemented Oregon ESSENCE in 2011. ESSENCE is an automated, electronic syndromic surveillance system that captures emergency department data from hospitals across Oregon. While each hospital system sends HL7 2.5.1-formatted messages, each uses a uniquely configured interface to capture, extract, and send data. Consequently, ESSENCE receives messages that vary greatly in content and structure.

January 25, 2018

ED visits for AMI, Stroke, ACS & COPD after the Statewide Smoking Ban in Cook Co., IL

Tobacco use is the leading global cause of preventable death, killing more than five million people per year. In addition, exposure to secondhand smoke is estimated to kill an additional 600,000 people globally each year. In 1986, the US Surgeon General’s Report declared secondhand smoke to be a cause of lung cancer in healthy nonsmokers. The first law restricting smoking in public places was enacted in 1973 in Arizona that followed the 1972 Surgeon General’s Report providing awareness of the negative health effects associated with the exposure to air pollution from tobacco smoke.

January 21, 2018

How do we present messy syndromic surveillance data to public health’s partners?

With increasing awareness of SyS systems, there has been a concurrent increase in demand for data from these systems – both from researchers and from the media. The opioid epidemic occurring in the United States has forced the SyS community to determine the best way to present these data in a way that makes sense while acknowledging the incompleteness and variability in how the data are collected at the hospital level and queried at the user level.

January 25, 2018

Maricopa County’s use of NSSP ESSENCE to detect cases during a hepatitis A outbreak

On 3/29/2017, the Maricopa County Department of Public Health (MCDPH) received three reports of confirmed HAV infection from an onsite clinic at Campus A that assists individuals experiencing homelessness, a population at risk for HAV transmission. To identify the scope of the problem, the department initiated rapid HAV infection case detection using NSSP ESSENCE.

Objective:

January 19, 2018

Surveillance for Mass Gatherings: NCAA Final Four 2017 in Maricopa County, Arizona

Final Four-associated events culminated in four days of intense activity from March 31st through April 3rd, and added an estimated 400,000 visitors to Maricopa County's 4.2 million residents.

Objective:

To describe and present results for the enhanced epidemiologic surveillance system established during the 2017 National Collegiate Athletic Association Division I Men’s College Basketball Championship (Final Four) events.

January 21, 2018

ED and poison center surveillance for the Great American Solar Eclipse in Oregon

Oregon’s statewide syndromic surveillance system (Oregon ESSENCE) has been operational since 2012. Non-federal emergency department data (and several of their associated urgent care centers) are the primary source for the system, although other data sources have been added, including de-identified call data from OPC in 2016. OPHD epidemiologists have experience monitoring mass gatherings and have a strong relationship with OPC, collaborating on a regular basis for routine and heightened public health surveillance.

January 25, 2018

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