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The SIDARTHa surveillance approach Kingston, Canada June 13, 2008

The SIDARTHa surveillance approach Kingston, Canada June 13, 2008. The European Emergency Data Group Research Network. European Emergency Data (EED) Group Research Network.

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The SIDARTHa surveillance approach Kingston, Canada June 13, 2008

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  1. The SIDARTHa surveillance approach Kingston, Canada June 13, 2008

  2. The European Emergency Data Group Research Network

  3. European Emergency Data (EED) Group Research Network • Loosely formed research network of European health researchers, clinicians, emergency physicians, EMS professionals and health authority officials • Aim: comparing EMS systems internationally, defining best practice and standard procedures, developing monitoring and surveillance concepts based on EMS data • since 1996 • partners in 19 European countries and one partner in the USA

  4. EED Group - Research Network Activities • 1996-2000: EED I & II - Comparing EMS in Birmingham (UK), Bonn (D) & Santander (ES) • 2002-2006: EED III - European Emergency Data-based Health Monitoring System (co-funded by European Commission) • 2004-2007: Involvement in EU Injury Data Base Development (Phase II) (co-funded by European Commission) • 2004-2008: Utstein Standard for European Emergency Medical Dispatch (co-funded by Leardal Foundation) • 2007-2010: SIDARTHa - European Emergency Data-based Syndromic Surveillance System (co-funded by European Commission)

  5. EED Group - Research Network Output • 1996: Krafft, T. and L. García Castrillo-Riesgo (ed.): Professionalisation or Marketisation in Health Care – EMS in Transformation. Bonner GeographischeAbhandlungen 95. Dümmler. Bonn. (English/German) • 2000: Krafft, T. et al. : European Emergency Data (EED) Project. Comparing European EMS Systems. Working Report II: Scope, Aims, Findings. Keese. Bonn. • 2003: Krafft, T. et al.: European Emergency Data Project (EED Project). EMS Data-based Health Surveillance System. In: European Journal of Public Health 13(3,Suppl): 85-90. • 2003: Fischer, M. et al.: Comparisonofeffectivenessandefficiencyofthe EMS systems in Birmingham (UK) and Bonn (D). In: Anästhesiologie, Intensivmedizin, Notfallmedizin Schmerztherapie 38: 630-642. (German) • 2004: Fischer, M. et al.: Comparisonofeffectivenessandefficiencyofthe EMS systems in Birmingham (UK) and Bonn (D). In: Der Notarzt 20: 51-63. Reprint. (German) • 2006: Krafft, T. et al.: Health Monitoring & Benchmarking of European EMS Systems: Components, Indicators, Recommendations. Project Report tothe European Emergency Data Project: EMS Data-basedHealthSurveillance System (SPC.2002299). Geomed Research Group. Köln.

  6. SIDARTHa The European Project

  7. General Objectives • to contribute to and to enhance the generic preparedness of the health sectorfor communicable as well as non-communicable health threats and emergencies • improvement of timeliness and cost-effectiveness of European and national surveillance providing a basis for systematic syndromic surveillance by • establishing a system that automatically will transfer, process and analyse near real-time emergency data and automatically provide spatial-temporal surveillance reports and alerts.

  8. Project Overview PHASE I - Conceptualisation PHASE II - Implementation Information Possibilities Evaluation Implemen-tation Needs Project Coordination Dissemination of Project Results Project Evaluation

  9. Administrative Project Structure WP 1 - Project Coordination WP 2 - Dissemination of Project Results WP 3 - Project Evaluation PHASE I - Conceptualisation PHASE II - Implementation WP 4 Best practice - local practice WP 7 Pilot Phase WP 5 EM data-based surveillance WP 6 Design & Callibration Workshop + Steering Committee Meeting Steering Committee Meeting only WP Work Package M Month of project time

  10. SpecificObjectives 1. Assessment of best and local practice of emergency data-based surveillance 2. Identification of health threats & definition of surveillance indicators 3. Identification of average demand patterns & thresholds for spatial-temporal clustering 4. Specification of user needs by experts from the relevant health sector target groups 5. Definition of algorithms of the system & specification of system design 6. Set-up of SIDARTHa 7. Test & evaluation of SIDARTHa’s performance & recommendations for future use

  11. Project Group • State Dispatch Centre Tyrol, Innsbruck/Austria GernotVergeiner • Federal Government, Department of Public Health, Organisation of Care Institutions, Brussels/Belgium • Agnes Meulemans • Emergency Medical Service Prague/Czech Republic • MilanaPokorna • Capital Region of Denmark, Devision of Planning and Development, Copenhagen/Denmark • Freddy Lippert • University Hospital, Department of Anaesthesiology and Intensive Care, Kuopio/Finland • JouniKurola • Emergency Medical Service for Province Hauts de Seine, Garches/France • Michel Baer • Hospitals of County of Goeppingen, Goeppingen/Germany Matthias Fischer • National Emergency Medical Service, Budapest/Hungary • Gabor Göbl • San Martino University Hospital, Genoa/Italy • Francesco Bermano • Haukeland University Hospital, Bergen/Norway • Guttorm Brattebo • University of Cantabria, Santander/Spain • Luis Castrillo • University Hospital, Antalya/Turkey • HakanYaman • Prof. Dr. Luis Garcia-CastrilloRiesgo (Spain) • emergency medicine, leader of a district EMS, emergency data analysis • Dr. Thomas Krafft (Germany) • health geography, experience in leading an EMS system, emergency data analysis, GIS/spatial-temporal analyses, EED Project leader • Prof. Dr. Freddy Lippert (Denmark) • emergencymedicine, national healthauthorityrepresentative, medicaldirectorof regional EMS • Ing. GernotVergeiner (Austria) •  EMS dispatch, leader of a high-performance state dispatch centre, emergency data analysis • Prof. Dr. Matthias Fischer (Germany) •  Emergency medicine, emergency data analysis, organiser of a state emergency medicine registry • Prof. Dr. Alexander Krämer (Germany) •  Public health, epidemiology/biometry, internal medicine, health surveillance • Universitad de Cantabria (Spain) – Financial issues • Geomed Research GmbH (Germany) – Technical issues • Prof. Dr. Helmut Brand – Professor for European Public Health, Head of Department of International Health, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Netherlands • Dr. EnricoDavoli- Programme Manager, World Health Organization Regional Office for Europe, Department for Emergency Medical Services, Barcolona/Spain • Prof. Dr. Javier Llorca- Professor for Public Health and Epidemiology, University of Cantabria, Santander/Spain • Jerry Overton, MA - Director, Richmond Ambulance Authority, USA; first site in the USA that implemented the emergency data-based surveillance system First Watch™ in 2002 • Dr. Santiago Rodriguez - Director, Health Service of District of Cantabria, Santander/Spain • Prof. Dr. Mark Rosenberg - Professor of Geography & Professor of Community Health and Epidemiology, Queen’s University, Kingston/Canada • N.N. - DG SANCO (Health Threat Unit) & ECDC • to be nominated by institutions • 2 – GEOMED - DE – Methodology of data processing, analysis, reporting • Subcontracting partners – Technical programming of data transfer, processing, analysis, reporting • SATYAM Computer Services, Inc. Hyderabad/India

  12. The European Health Surveillance Complex

  13. EU surveillanceconcept

  14. European Health Emergency Network - Actors European Commission’s Directorate General Health and Consumers Other European Commission’s Directorates General European Centre for Disease Prevention and Control European Commission’s Health Threat Unit (HTU) Emergency Operations Centre Health Emergency Operations Facility (HEOF) World Health Organization Regional Office for Europe 27 EU Member States Health Ministries

  15. European HealthSurveillance / Alert Network European Commission’s Directorate General Health and Consumers Other European Commission’s Directorates General European Centre for Disease Prevention and Control Other Alert Systems Dedicated Surveillance Networks / TESSy EWRS/Rapid Alert Systems MedISys World Health Organization Regional Office for Europe 27 EU Member States Health Ministries National Surveillance Systems CISID / GOARN

  16. DSN – DedicatedSurveillance Networks • BSN = Basic Surveillance Network • DIPNET = The Diphtheria Surveillance Network • DIVINE = Prevention of emerging (food-borne) enteric viral infections • EARSS = European Antimicrobial Resistance Surveillance System • EISS =The European Influenza Surveillance Scheme • ENIVD = European Network for Diagnostics of “Imported” Viral Diseases • Enter-net = Dedicated surveillance network for enteric pathogens • ESAC = European Surveillance of Antimicrobial Consumption • ESSTI = European Surveillance of Sexually Transmitted Infections • EUCAST = European Committee on Antimicrobial Susceptibility Testing • EU-IBIS = Invasive Bacterial Infections Surveillance in the European Union • EuroCJD = European Creutzfeldt Jakob Disease Surveillance • EuroHIV = European Centre for the Epidemiological Monitoring of AIDS • EuroTB = Surveillance of Tuberculosis in Europe • EUVACNET = A Surveillance Community Network for Vaccine Preventable Diseases • EWGLINET = European Surveillance of travel associated legionnaires’ disease • IPSE = Improving Patient Safety in Europe

  17. EWRS – Early Warningand Response System

  18. MedISys – Medical Intelligence System

  19. SIDARTHa The Anticipated Surveillance System

  20. Intended System Design MedISys Emergency Professionals Risk Communication Platform European Health Surveillance System EWRS Automatic Data Processing/ Analysis Website DSN/ RAS Automatic Data Transfer LocalHealth Surveillance System LocalHealth Surveillance System LocalHealth Surveillance System LocalHealth Surveillance System Alert Communication/Support National Health Authority DSN Dedicated Surveillance Network (disease specific) Hospital A EMS A Hospital B EMS B EWRS Early Warning & Response System LocalHealth Authority MedISys Medical Intelligence System RAS Rapid Alert Systems, e.g., RAS-CHEM (chemical emergency)

  21. Intended System Design – Local Level Emergency Professionals Risk Communication Platform European Health Surveillance System LocalHealthSurveillance System Automatic Comparison with Threshold GIS-based Automatic Generation of Spatial-Temporal Thresholds Automatic Syndrome Generation Automatic Historical Data Analysis Automatic Data Cleansing LocalHealth Authority EMS A

  22. Intended System Design – European Level Emergency Professionals Risk Communication Platform European HealthSurveillance System European Report / Alert National Report / Alert GIS-based Analysis Tool Local Report / Alert LocalHealth Surveillance System LocalHealth Surveillance System LocalHealth Surveillance System

  23. SIDARTHa – System‘sStrengths • Local surveillance unit based at single institution • Aggregation level low: takes local specificities into account • Reduces data volume • Reduces trouble with privacy/data protection (no raw data leaves the institution) • Increases acceptance and distribution • European surveillance unit • Enabling cross-border surveillance (local-regional-national-EU levels) • Risk communication for emergency professionals between institutions • Real-time routine data transfer • No batch transfer, but real-time transfer right after incidence • No manual data input, no additional staff time

  24. Thank you!

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