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Syndromic Surveillance Eryn Murphy October 12, 2011

Syndromic Surveillance Eryn Murphy October 12, 2011. Syndromic Surveillance. Syndromic surveillance systems use existing health data in real time to provide immediate analysis and feedback to public health officials Detects syndromes rather than specific diagnoses

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Syndromic Surveillance Eryn Murphy October 12, 2011

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  1. Syndromic SurveillanceEryn MurphyOctober 12, 2011

  2. Syndromic Surveillance Syndromic surveillance systems use existing health data in real time to provide immediate analysis and feedback to public health officials Detects syndromes rather than specific diagnoses Designed to detect and/or monitor outbreaks Near real time data reporting allows for timely assessment and action

  3. Nebraska’s Emergency Department Syndromic Surveillance • Emergency Department (ED) records occurring the previous day are sent electronically to NDHHS • Production data from 8 ED facilities, test data from 5 ED facilities • Comprises ~25% of all ED visits in NE • Originally established to track influenza like illness (ILI) • Now used for many different health outcomes including • Sexual Assault • Heat Related Injuries • Acute Cardiovascular Events • Diarrheal Diseases • Gastrointestinal Disease Outbreaks

  4. Nebraska’s Emergency Department Syndromic Surveillance • 48 data elements • Demographic Data • Clinical Data • Influenza Like Illness Indicators • Records are filled in as they mature • ICDM9 Codes, demographic data, etc…

  5. Nebraska’s Emergency Department Syndromic Surveillance • Syndromes are identified using free text chief complaint fields, triage notes, and ICD9 diagnostic codes • SAS algorithms scan free text for key words • More timely than final diagnosis codes or lab report results

  6. Nebraska’s Inpatient Surveillance System • Near real-time tracking of acute cardiovascular events in Nebraska residents from electronic inpatient hospital discharge data • Acute myocardial infarction (AMI) • Coronary artery bypass graft (CABG) • Angioplasty • Stent placement • Traditional syndromic surveillance using ED data does not include • procedures • patient level exposures

  7. Nebraska’s Inpatient Surveillance System • One pilot hospital in Omaha • 128 data elements • Clinical received 5 days after admission • Demographic Data received 24 hours after coding • Anomalies detected with historical baseline data comparison

  8. Cardiovascular Disease Data Elements • Demographic Data • Patient data • Geographic • Workplace • Clinical Data • Diagnostic and Procedure ICD codes • Vital Signs • Medication Lists • EKG Interpretations • CVD Risk Factors

  9. Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE) • Syndromic surveillance system for capturing and analyzing public health indicators to detect various syndromes • Capable of ingesting, processing, and visualization a variety of health indicator data • Create charts, tables, graphs and time series reporting • Combines temporal and spatial anomaly detection • Anomaly detection capability when compared with historical data • Web-based information distribution back to providers and health departments

  10. ESSENCE • Possible Future Health Indicator Data Sources • Outpatient • Over the counter sales • Animal health • Diagnostic Labs • Hotlines (poison control) • Absenteeism reports

  11. ESSENCE • Syndromes • Influenza like illness • Cough, fever, sore throat… • Cardiovascular • Chest pain, SOB, MI, heart attack… • Gastrointestinal • Peritonitis, vomiting, diarrhea, cramps… • Rash • Hives, measles, pox, vesicles, folliculitis… • Respiratory • Dyspnea, respiratory, wheezing, SOB…

  12. Benefits NDHHS will analyze data and provide LHDs and data providers with access to static charts, tables and graphs ESSENCE provides interactive, user-friendly access to customized, user defined data analysis via secure, web based remote access Scarce resources may be used more effectively by identifying high priority and high cost health problems, vulnerable populations, and other trends

  13. Benefits • Creating and strengthening cross jurisdictional public health programs and collaborations • State and local health departments will have a better understanding of Tribal communities’ health needs • Better health promotion, prevention, and treatment programs • Tribal health officials can monitor community health trends with data from their own facilities

  14. Next Steps • NDHHS can assist Tribal health officials with • Establishing electronic health records • File specifications • Secure data transfer

  15. Questions

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