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Jonathan Anderson, MPH Bureau of Epidemiology Utah Department of Health

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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Jonathan Anderson, MPH Bureau of Epidemiology Utah Department of Health

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  1. 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

  2. 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

  3. 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

  4. Contextual inquiry approach

  5. Results • 61-Step “Work Process” Document: • Steps in enteric disease investigation. Wish list items Limitations • Possible Intervention Steps • Q & A • Appendices (Artifacts)

  6. Work process steps Links to Appendices Wish list item

  7. 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%)

  8. 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.

  9. 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.

  10. 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

  11. 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?

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