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Veteran Affairs

Description

Under leadership of the Secretary of Veterans Affairs (VA), Office of Operations, Security and Preparedness has established the Veterans Affairs Integrated Operations Center, with the goal of enhancing integration and analysis of data, and information from VA’s preparedness partners, both internal and external, for timely decision support. The Office of Operations, Security and Preparedness oversee emergency preparedness for the VA, which includes responsibility for preparedness activities at Veterans Health Administration (VHA). The VHA provides medical care to over 5 million patients a year at 153 medical centers, and over 900 outpatient clinics in the United States, and the United States territories. The Office of Operations, Security and Preparedness is developing a VA–Subject Matter Expertise Center for Biological Events in collaboration with the VHA–National Infectious Diseases Program Office. The Subject Matter Expertise Center for Biological Events is initiating pilot projects to examine data sources, integration, and predictive analysis. The recent increase in dengue cases internationally prompted the Office of Operations, Security and Preparedness, and the Subject Matter Expertise Center for Biological Events to establish collaborations, and investigate factors influencing dengue disease patterns in VHA facilities. The National Weather Service has the mission to provide weather, water and climate data, forecasts and warnings for the protection of life and property, and enhancement of the national economy. The Veterans Affairs Integrated Operations Center enabled collaboration with the National Weather Service for integration of weather, water and climate data, and retrospective analysis into preparedness activities.

Objective

The objective of this study is to describe Veterans Affairs Integrated Operations Center-enabled collaborations to enhance the synergy of relevant data/information from Veterans Affairs (VA) and non-VA partners for improved early warning, and situational awareness of infectious disease threats.

Submitted by teresa.hamby@d… on
Description

Under leadership of the Secretary of Veterans Affairs (VA), Office of Operations, Security and Preparedness has established the Veterans Affairs Integrated Operations Center, with the goal of enhancing integration and analysis of data, and information from VA’s preparedness partners, both internal and external, for timely decision support.

Objective

The objective of this study is to describe Veterans Affairs Integrated Operations Center-enabled collaborations to enhance the synergy of relevant data/information from Veterans Affairs (VA) and non-VA partners for improved early warning, and situational awareness of infectious disease threats.

Submitted by uysz on
Description

Current influenza-like illness monitoring in Idaho is on the basis of syndromic surveillance using laboratory data, combined with periodic person-to-person reports collected by Idaho state workers. This system relies on voluntary reporting. Electronic medical records with relational databases offer a method of obtaining data in an automated fashion. Clinical data entered in CPRS includes real-time visit information, vital signs, ICD-9, pharmacy, and labs. ICD-9 and vital signs have been used to predict influenza-like illness in automated systems. We sought to combine these with lab and pharmacy data as part of an automated syndromic surveillance system.

Objective

The objective of this paper is to study whether syndromic surveillance using data from the Veterans Administration electronic medical record computerized patient record system (CPRS) correlates to officially reported influenza activity levels in the State of Idaho.

Submitted by uysz on
Description

There are a number of Natural Language Processing (NLP) annotation and Information Extraction (IE) systems and platforms that have been successfully used within the medical domain. Although these groups share components of their systems, there has not been a successful effort in the medical domain to codify and standardize either the syntax or semantics between systems to allow for interoperability between annotation tools, NLP tools, IE tools, corpus evaluation tools and encoded clinical documents. There are two components to a successful interoperability standard: an information and a semantic model.

Objective

The Consortium for Healthcare Informatics Research, a Department of Veterans Affairs (VA) Office of Research and Development is sponsoring the development of a standard ontology and information model for Natural Language Processing interoperability within the biomedical domain.

Submitted by uysz on
Description

Group A beta-hemolytic Streptococcus (GABHS) has caused outbreaks in recruit training environments, where it leads to significant morbidity and, on occasion, has been linked to deaths. Streptococcal surveillance has long been a part of military recruit public health activities. All Navy and Marine Corps training sites are required to track and record positive throat cultures and rapid tests on weekly basis. The Navy and Marine Corps have used bicillin prophylaxis as an effective control measure against GABHS outbreaks at recruit training sites. Though streptococcal control program policies vary by site, a minimum prophylaxis protocol is required and mass prophylax is indicated when local GABHS rates exceed a specific threshold. Before July 2007, prophylaxis upon initial entry was required between October and March, and when the local rate exceeded 10 cases per 1000 recruits. In July 2007, the Navy instituted a policy of mass prophylaxis upon initial entry throughout the year. Evaluation of GABHS cases before and after implementation of the new policy, including overall rates, identification of outbreaks, and inpatient results will help enhance the Navy’s ability to evaluate threshold levels, provide  systematic/standardized monitoring across the three recruit sites, and inform prophylaxis and monitoring strategies.

 

Objective

To compare trends of GABHS among recruits before and after changes in prophylaxis implementation using electronic laboratory and medical encounter records.

Submitted by hparton on
Description

Medically unexplained syndromes (MUS) are conditions that are diagnosed on the basis of symptom constellations and are characterized by a lack of well-defined pathogenic pathways. The three most common MUS are chronic fatigue syndrome, irritable bowel syndrome, and fibromyalgia. Different types of persistent symptoms, originating from different organ systems, characterize these syndromes. Patients often meet the criteria for more than one MUS.

 

Objectives

We sought to develop a guideline and annotation schema that can be consistently applied to identify MUS found in VA clinical documents. These efforts will support building a reference standard used for training and evaluation of a Natural Language Processing system developed for automated symptom extraction. Our overarching goal is to characterize the occurrence of MUS in Operation Enduring Freedom/Operation Iraqi Freedom veterans.

Submitted by hparton on
Description

Current influenza-like illness (ILI) monitoring in Idaho is based on syndromic surveillance using laboratory data, combined with periodic person-to-person reports collected by Idaho state workers. This system relies on voluntary reporting.

Electronic medical records offer a method of obtaining data in an automated fashion. The Computerized Patient Record System (CPRS) captures real-time visit information, vital signs, ICD-9, pharmacy, and lab data. The electronic medical record surveillance has been utilized for syndromic surveillance on a regional level. Funds supporting expansion of electronic medical records offer increased ability for use in biosurveillance. The addition of temporo-spatial modeling may improve identification of clusters of cases. This abstract reviews our efforts to develop a real-time system of identifying ILI in Idaho using Veterans Administration data and temporo-spatial techniques.

 

Objective

The objective of this study is to describe initial efforts to establish a real-time syndromic surveillance of ILI in Idaho, using data from the Veterans Administration electronic medical record (CPRS).

Submitted by hparton on
Description

The Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) obtains electronic data from 153 Veterans Affairs (VA) Medical Centers plus outpatient clinics in all 50 states, American Samoa, Guam, Philippines, Puerto Rico, and U.S. Virgin Islands. Currently, there is no centralized VA reporting requirement for nationally notifiable infectious conditions detected in VA facilities. Surveillance and reporting of cases to local public health authorities are performed manually by VA Infection Preventionists and other clinicians. In this analysis, we examined positive predictive value of ICD-9-CM diagnosis codes in VA ESSENCE to determine the utility of this system in electronic detection of reportable conditions in VA.

 

Objective

To determine the utility of ICD-9-CM diagnosis codes in the VA ESSENCE for detection and public health surveillance of nationally notifiable infectious conditions in veteran patients.

Submitted by hparton on
Description

Microorganisms resistant to antibiotics (ABX) increase the mortality, morbidity and costs of infections. In the absence of a drug development pipeline that can keep pace with the emerging resistancemechanisms, these organisms are expected to threaten public health for years to come. Because exposure to ABX promotes the development of bacterial resistance, health care providers have long been urged to avoid using antibiotics to treat conditions that they are unlikely to improve, including many uncomplicated acute respiratory infections. We asked if interposing clinical decision support software at the time of electronic order entry could adjust ABX utilization toward consensus guidelines for these conditions. 

Submitted by hparton on
Description

There are currently no federal laws mandating the reporting of infectious diseases to public health authorities. Reporting requirements reside at the state level and such laws do not apply to federal agencies including the VA. Heretofore, VA's reporting of infectious diseases to public health authorities has been strictly voluntary, and has been accomplished via traditional methods (phone, mail, and fax) that are highly prone to human error, create a significant administrative burden, and do not adequately safeguard the privacy of Veterans' data. Previously, without a reporting mandate applicable to VA facilities, public health authorities have had an incomplete picture of the VA contribution to the overall infectious disease burden existing in the larger population. Moreover, at a national level, the VA has not had the ability to monitor the prevalence of the various infectious diseases within its own 151 hospitals and 827 community-based outpatient clinics. Nor has the VA been able to meet the spirit of the Health Information Technology for Clinical and Economic Health Act's Meaningful Use requirements, mandating electronic exchange of information.

Objective

In June 2013, in anticipation of the passage of proposed federal legislation (S 875 and HR 1792), the Department of Veterans Affairs (VA) issued a Directive requiring mandatory reporting of infectious diseases to various public health authorities (VHA Directive 2013-008). In terms of implementation strategies, the ideal is to build on an existing technology, optimize the quality and completeness of reporting, and minimize additional work burdens on VA staff.

Submitted by knowledge_repo… on