User's Experience

The Centers for Disease Control and Prevention (CDC) launched the BioSense program in 2003 to establish an integrated system of nationwide public health surveillance for the early detection and assessment of potential bioterrorism-related illness. Over the ensuing years, the original aims of BioSense were broadened to meet evolving public health surveillance needs and priorities.

In 2009, CDC embarked on a redesign of the BioSense system that would retain the original purpose of early event (or threat) detection and characterization, but enhance the capacity for situation awareness, event response, and routine public health practice. The BioSense redesign will be accomplished through continuous involvement of state and local users, and technical experts in the planning, design, development, and testing phases of the new BioSense system.

Objective

The objective of this poster presentation is to provide information on the efforts and results of the user requirements gathering process, pursued in the redesign of the BioSense system employing a User-Centered Design (UCD) approach. A UCD system development approach studies the people that the system will serve, and involves them through the planning, design, and development processes.

Modern information and communication technologies have increasingly prominent roles in health care systems. To capitalize on attainable benefits, it is essential to thoroughly and purposefully weave them into the existing business processes. The challenges of doing so can be exacerbated by specific local circumstances of developing countries. We

share our experiences from fielding a system designed to support real-time collection and analysis of public health data in rural areas of Sri Lanka and India. Its strong transformational potential has been proven, however, success of the ultimate field use requires overcoming multiple organizational and utility challenges.

Objective

We review challenges faced during the initial period of implementation of a Real-Time Biosurveillance Program in developing countries.

Funded by the Army’s Telemedicine and Advanced Technology Research Center, we developed the BioSINE toolset to provide visualization and collaboration capabilities to improve the accessibility and utility of health surveillance data. Investigation of public health (PH) practitioners’ needs with cognitive engineering methods revealed two key objectives: 

1. To provide analysts and decision makers with an intuitive, visually driven workspace. 

2. To support a web presence to provide rapid updating and facilitate greater interaction with data analysis in the PH community.

To better serve under-resourced PH organizations, both domestic and abroad, it is necessary to minimize information technology requirements and expertise in complex analytic tools.

BioSINE provides decision makers with the ability to create customized visualizations, focus on specific aspects of the data, or conduct hypothesis testing. Users can also view or hide variables, specify data ranges, and filter data relevant to their interests. Figure 1 shows a display in which a user investigated seasonal effects by narrowing the analysis to the summer months. Intuitive filtering is a key characteristic of the application to quickly produce snapshots of local interests.

Objective

BioSINE strives to improve situational awareness by making data visualization and collaboration capabilities intuitive and readily available for a wide range of PH stakeholders.

The BioSense program’s mission is to support and improve public health surveillance infrastructure and human capacity required to monitor (with minimal lag) critical population health indicators of the scope and severity of acute health threats to the public health; and support national, state, and local responses to those threats. This mission is consistent with the 2006 Pandemic All Hazards Preparedness Act, and 2007 Homeland Security Presidential Directive (HSPD-21), both of which call for regional and nationwide public health situational awareness, through an interoperable network of systems, built on existing state and local situational awareness capability.

Objective

The objective of this study is that the Centers for Disease Control and Prevention will update the International Society for Disease Surveillance community on the latest activities for the BioSense program redesign (Centers for Disease Control and Prevention, USA).

Secure and confidential exchange of information is the cornerstone of public health practice. Often, this exchange has to occur between public health agencies across jurisdictions. Examples include notification of reportable diseases when the testing and residence of the patient are in different counties. The cross-jurisdictional issues become exaggerated in times of communicable disease outbreaks or events of interest that are not yet classified as outbreaks. Currently, such communication occurs between state and local agencies and between agencies and community clinicians on a personal level, with phone, fax and snail mail. There are a multitude of secured websites hosted by the Utah Department of Health (UDOH) that offer access to single applications requiring approved users to remember multiple sites and logins/passwords. The goal of this project was to develop a centralized, single sign-on secure web portal, from which users could access multiple applications and communicate securely with each other.

Objective

There is an urgent need for improved communication between stakeholders involved in outbreak investigations, public health reporting and events of interest occurring between different jurisdictions within the same state. Currently, state and local public health agency personnel rely on personal communications involving phone, fax and snail mail. UDOH sought to develop and encourage the use of a secured web portal that allows access to a variety of applications using a single sign-on. This was achieved by developing a secured communications framework called PHAccess that allows tools and applications to be implemented within a secure web environment, using open source software and Agile methodology techniques. The user-centric design currently hosts an electronic report-staging area, ELR/EMR reporting, webbased reporting, secure messaging between stakeholders and a state laboratory result look-up feature. Currently, there are over 700 registered users; 3693 secure messages that have been exchanged and the site has been accessed over 12,205 times since January 2009. Informal feedback from users has been encouraging and formal evaluation is planned, along with expansion and integration with state level health information exchange projects. 

Syndromic surveillance data have been widely shown to be useful to large health departments. Use at smaller local health departments (LHDs) has rarely been described, and the effectiveness of various methods of delivering syndromic surveillance data and information to smaller health departments is unknown. Syndromic surveillance data and information in North Carolina are available to all local public health staff by several routes. This report characterizes LHD access to syndromic surveillance data and information and their use for key public health purposes.

Objective

To characterize use of syndromic surveillance information for key public health functions at the local health department level, and to make recommendations to facilitate use of syndromic surveillance data for these functions.