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Information technology for surveillance Can information tools improve surveillance?. Denis Coulombier ECDC. New information technologies The technology paradox. A new technology may have a negative impact on productivity if used without a change of approach
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Information technology for surveillanceCan information tools improve surveillance? Denis CoulombierECDC
New information technologiesThe technology paradox • A new technology may have a negative impact on productivity if used without a change of approach • New technologies require a change of practices to give their full benefit
The technology paradoxHow it applies to information? Epiinfo 1, 1985 Epiinfo 2/3, 1987 Epiinfo 6, 1994 From data compilation … to decision-making
Information technologies anddata collection • Benefit • Computerised data entry • Fast data transfer • Structured data • Prerequisites • Case definitions • Appropriate data models
Information technologies anddata analysis • Benefits • Fast compilation • Computation of indicators (rates, standardized rates…) • Thresholds • Prerequisites • Appropriate hypotheses • Defined plan of analysis
Information technologies anddata presentation • Benefits • Tables, maps and charts • Automated reports • Prerequisites • A guide to data review • A decision-making approach
The Serbia Alert Project • March 2003 • Request to WHO to computerised the early warning system • 73 diseases under mandatory notification • 20 agegroups • Monthly aggregation at national level • No computerized analysis
The Serbia Alert Project • May 2003: in-depth assessment • Need for prioritization of CD under early warning surveillance: workshop • Need for syndromic case definitions • Need for guidelines on investigation and control measures • Need for change in surveillance regulations
The Serbia Alert Project Strengthening Strategy A structured and integrated approach to epidemiologicalsurveillance and response strengthening Risk assessment Monitoring andevaluation Prioritization In-depthassessment Implementation Plan of action
The Serbia Alert Project Risk Assessment • Public health risks change over time • Emerging and re-emerging diseases • Changes in epidemiological profile • New strains (meningitis W135) • Antibiotic resistance • Advanced technology, improved knowledge • New vaccines, control programmes • Demographic changes • Environmental changes Output: risk assessment fact sheets
Prioritization of Communicable Diseases • Changing risks and priorities • Limited human and financial resources • Priority to diseases of public health importance • Short list of diseases for efficiency • Consensus process • 3 day workshop Output: list of priorities for surveillance and EWARS
Assessing National Capacities for Surveillance and Response In-depth assessment helps to identify • Strengths and weaknesses of a system • Meeting the priorities identified • Areas for improved coordination • Areas for integration • Ways for improvement • Baseline information to allow measurement of progress Output: assessment report and recommendations
: Development of National Surveillance PoA • Objective: Effective national multi-diseases (integrated) system with an early warning component • Involvement of key stakeholders in surveillance • Ensuring coordination • Prioritizedstrategic plan (3-5 years) with annual operational plans • Costing and identification of funding source Output: a framework in which donors and partners can buy in
Implementation of EWARS • Prerequisites to implementation of EWARS • Defining functional specifications: EWARS core functions • Defining technical specifications: EWARS support functions • Defining the implementation plan • Implementing EWARS Output: an efficient early warning system WHO Guidelines on Implementation of National Early Warning and Response Systems EWARS June 2004
Reporting districts by WeekEarly Warning System in Albania, 2000
Conclusion • Information technologies are just tools! • If not part of a strengthening process, they will fail in improving the early warning function • Monitoring and evaluation is required