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Additional Data For Harmonized Use Case for Biosurveillance. HINF 5430 Final Project By Maria Metty, Priyaranjan Tokachichu &Resty Namata December 13, 2007. Agenda. Brief History of Outbreak Harmonized Use Case for Biosurveillance Proposal Costs and Financial Benefits Impact
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Additional Data For Harmonized Use Case for Biosurveillance HINF 5430 Final Project By Maria Metty, Priyaranjan Tokachichu &Resty Namata December 13, 2007
Agenda • Brief History of Outbreak • Harmonized Use Case for Biosurveillance • Proposal • Costs and Financial Benefits • Impact • Recommendation • Questions
Harmonized Use Case for Biosurveillance Brief History 1979 - Accidental release of anthrax from bio-weapons plant inSverdlovsk, Russia • 6 people with flu-like symptoms not treated & 21 people had died before lab results confirmed anthrax After September 11, 2001 • Anthrax release in United States November 2002 to 31 July 2003 • Severe Acute Respiratory Syndrome in Asia • WHO estimates up-to 60 % of cases were Healthcare workers • What is Biosurveillance Use Case • Specifications given by American Health Information Community for • implementing a Biosurveillance system.
Use Case Requirements Transmit real-time data from electronically enabled healthcare providers to Public health Agency within 24hr lag time. Real-time Fulfilled by data transmission from HER Timeliness Define by Michael Wagner et al. as difference between time of event detection & time event occurred Goal: Early detection Need early detection of natural or man-made disease outbreak in order to mobilize resources and minimize morbidity and mortality
Importance of early detection Traditional Disease Detection Early Detection Gain of 2 days Phase II Acute Illness Phase I Initial Symptoms • Category A disease agents cause non-specific symptoms like fever, cough, fatigue • People don’t seek medical care during effective treatment period. • 42% of people with “flu” symptoms purchased over-the-counter (OTC) • medication prior seeking medical care. • Use Case Data is collected after lab results and diagnosis Effective Treatment Period
Proposal Collect daily sales data of over-the-counter (OTC) healthcare product such as electrolytes, diarrhea, cough, thermometer and fever medications from retail stores and transmit it to public health agency within 24-hour time lag • It has been correlated with disease outbreak. • It is routinely collected for supply chain management • Available from National Retail Data Monitor System • It is low cost
Modified BiosurveillanceUse Case context diagram Clinician Hospital Laboratory Organization Retail Pharmacy Store Public Healthcare Agency Transmit /Receive essential ambulatory care Transmit /Receive ED visits & Utilization Transmit /Receive essential lab results Send /Receive acknowledgement Transmit Sales OTC sales data Current scenario Amended scenario
Scope Includes: Data electronically collected during a routine OTC product sale of pediatric electrolytes, “flu” remedies, chest rubs, diarrhea remedies, thermometer, adult & child anti-fever. Excludes: Sales data of other OTC healthcare products for symptoms not caused by infectious agents e.g allergy Customer identification information.
OTC-Sales Data √ Standard Product identifier √ Purchase Date √ Sales Total √ Product Description √ Category √ Store Identifiers √ Other Information • Stakeholders • Retails Stores that sell OTC healthcare products • Customers who purchase OTC healthcare products • Pre-Conditions • Procedures and agreements signed for data exchange • Post-Conditions • Data transmitted to an authorized Public Health agency • Acknowledgement sent back to sender
Recommendation We Recommend adding this data with reservations because: It is difficult for public health to understand the data OTC Data is noisy 3. Impossible to identify a person who purchased a product. 4. Due to competitive agreements the store cannot be identified either.
Special Thanks to: • Dr. Lael Gatewood • Dr. Richard Pham • Mr. Joseph Plasek • Jayne Griffith Senior Epidemiologist Bioterrorism Unit Minnesota Department of Health 651.201.5085 Jayne.griffith@health.state.mn.us • M. Cleat Szczepaniak • Program Manager of National Retail Data Monitor and Pennsylvania RODS • 412.648.6728