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Contextual Inquiry of Enteric Disease Outbreak Investigation Processes to Improve Visualization Capacity for Public Health Surveillance. Jonathan Anderson, MPH Bureau of Epidemiology Utah Department of Health. INTRODUCTION .
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Contextual Inquiry of Enteric Disease Outbreak Investigation Processes to Improve Visualization Capacity for Public Health Surveillance Jonathan Anderson, MPH Bureau of Epidemiology Utah Department of Health
INTRODUCTION • Inform visualization tool (Epinome) development & implementation 1 - Describe existing work processes (user stories) 2 - Identify: - decision making milestones - intervention steps - wish-list items - limitations
METHODS • Data collection: Contextual inquiry • Participants: Domain expert – UDOH Enteric Diseases Epi Interviewer – UDOH Epi UDOH Deputy State Epi CoE Project Manager Computer Scientist Other CoE members
Results • 61-Step “Work Process” Document: • Steps in enteric disease investigation. Wish list items Limitations • Possible Intervention Steps • Q & A • Appendices (Artifacts)
Work process steps Links to Appendices Wish list item
RESULTS 61-step Work Process Document LHD Involvement 22 steps (36%) UPHL Involvement 12 steps (20%) UT-NEDSS data used 13 steps (21%) Non-NEDSS data used 26 steps (43%) Manual data entry 15 steps (25%) Data analysis & visualization 10 steps (16%)
Example • NEDSS Database Use: 38.The Enteric Disease Epidemiologist uses NEDSS as a record keeping tool, a place to enter/record: a) lab results, b) outbreak names/codes, and c) case status (e.g. Confirmed, Not a Case, Suspect, Probable, etc). • The Enteric Disease Epidemiologist enters information into a spreadsheet (Appendix H) from NEDSS. However, NEDSS is typically not updated with information on risk factors & exposures in the spreadsheet. Therefore, as the investigation progresses the spreadsheet becomes the most current source of data.
Example • Data analysis & visualization: 36. The Enteric Disease Epidemiologist uses the spreadsheet (Appendix H) to analyze the outbreaks. • “Analysis” is an ongoing process, beginning as soon as two cases with matching PFGE patterns are identified. • Analysis in this sense involves searching the spreadsheet (Appendix H) for commonalities. • Variables that are commonly analyzed include: Age, Exposures, Date of onset, Location.
IMPACT • Enhanced communication of ideas among participants • Unique approach/model: “This approach to design provides an important model for other researchers and practitioners to design usable systems that fit with and expand on existing practice.” “Academic informatics does not have a good insight into how departments of health function so this paper nicely addresses this gap.” • Created map for development team • Able to compare & validate with other epis
Key Points: • Analysis of PH work processes • Contextual inquiry • Collaborative effort • Detailed (61 step) work process document • Guide software dev to support PH practice • Mapping of additional diseases?