Fridays from the Archives: Surveillance & Integration

Friday, February 21, 2014: Surveillance & Integration

Public health practitioners are increasingly focused on understanding cross-border syndromic surveillance data. Here in the US, ISDS encourages inter-state data understanding and sharing through regional workshops. In Europe, practitioners have been working since 2010 on gathering data and creating a framework for integrating syndromic surveillance. This has occurred under the scope of work of the Triple-S project. 

In 2012 Duncan Cooper, a Registrar in Public Health under the UK's National Health Service,  spoke about gathering data from European countries on their syndromic surveillance systems. In Towards Integrated Syndromic Surveillance in Europe?, Dr. Cooper describes Triple-S's work to meet the objective of "increasing the European capacity for real-time or near-real time surveillance and monitoring the health burden of expected and unexpected health related events". 

First, the presentation addresses practical concerns. Prior to integrating syndromic surveillance systems, the project needs data. Not syndromic surveillance data, per se, but metadata on the systems themselves. For instance, who are the key stakeholders? What are individual syndromic surveillance systems used for? Is there even a syndromic surveillance system in all target countries?

To answer these questions the Triple-S project team identified key stakeholders and lined up site visits throughout Europe. They also sent questionnaires to 28 European Union countries, including subsequent in-depth follow up questionnaires. With this data, the project progressed to identifying next steps, including developing a minimum dataset, communication materials, common evaluation criteria, and checklists. 

Perhaps most importantly, this project established trust and communication between a variety of public health jurisdictions. Going forward, the EU can integrate reporting on syndromic surveillance functions such as outbreak detection and general public-health surveillance, a vital function in a very inter-connected world.

This post is part of the series Fridays from the Archives. You can access all posts in the series here.

Written by Becky Zwickl, MPH, ISDS Public Health Analyst (bzwickl@syndromic.org).

CSTE Webinar on the ACA and Health Care Integration: February 12th, 1 pm ET

On Wednesday, February 12, 2014 from 1-2pm EST, CSTE will be hosting a webinar entitled Notes from the Field: Oregon’s and Illinois’ Experiences with Public Health and Health Care Integration.  This webinar will characterize the role of the epidemiologist in a post-ACA environment.

After this webinar, participants will be able to:

1. Describe the role of the epidemiologist in a post-ACA environment.
2. Describe the importance of metrics for successful public health and primary care integration efforts.

The webinar will be presented by Katrina Hedberg, State Epidemiologist in Oregon, and Craig Conover, State Epidemiologist in Illinois.

Topic: Feb. Primary Care Integration Call 

Host: Jessica Pittman 

Date: Wednesday, February 12, 2014 

Time: 1:00 pm, Eastern Standard Time (New York, GMT-05:00) 

Session number: 792 743 127 

Session password: epi1234 

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To join the session 

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1. Go to https://cste.webex.com/cste/k2/j.php?MTID=tef337c6156deb092061e945b8a522ff8 

2. Enter your name and email address (or registration ID). 

3. Enter the session password: epi1234 

4. Click "Join Now". 

5. Follow the instructions that appear on your screen.

Fridays from the Archives: Meaningful Use & Ambulatory Data

Friday, February 7, 2014: Meaningful Use & Ambulatory Data

It's the first Friday of the month, which means the Meaningful Use Community Call is this afternoon (more info here). These calls act as a platform for public health practitioners to discuss their status with implementing the syndromic surveillance objective of Meaningful Use, often looking towards future Meaningful Use stages. We've had many discussions surrounding what to do with Eligible Professionals, or EPs, who are interested in submitting data. Currently, many jurisdictions are putting these EPs in queues until they have the capacity to process their data. 

But why is receiving ambulatory data an issue at all? What makes ambulatory data unique from existing Emergency Department (ED) data?

One of the largest challenges in incorporating ambulatory data is sheer volume. Corey Spears and Michelle Siefert plainly lay out this dilemma in Discovering the New Frontier of Syndromic Surveillance: A Meaningful Use Dialogue on Inpatient and Ambulatory EHR Technology. At an ED visit the patient, at least ostensibly, is encountering some type of emergency to prompt the visit. In ambulatory settings, routine visits are common. Additionally, there are a wide variety of ambulatory care providers. Do public health departments want data from internists? Almost certainly. But do they also want data from dermatologists? That's a bit less certain.

This webinar is particularly interesting because it presents the information from the perspective of EHR vendors, an important stakeholder group that has substantial investment in Meaningful Use processes.

Interested in learning more? Join our Meaningful Use Community calls and view the webinar recording on the ISDS website.

This post is part of the series Fridays from the Archives. You can access all posts in the series here.

Written by Becky Zwickl, MPH, ISDS Public Health Analyst (bzwickl@syndromic.org). 

Fridays from the Archives: Schools & Flu

Friday, January 24, 2014: Schools & Flu

Schools are often, for lack of a better descriptor, prime places for infectious disease transmission. But how do common infectious diseases, like seasonal influenza, move through a school? Are there specific patterns that could be accounted for to mitigate transmission?

It turns out that certain factors, such as social networks, may affect not only epidemic impact but also intervention effectiveness.  Through extensive modeling Gail Potter, PhD explores these social contact factors in School Disease Transmission: Has the time come for coordination between monitors and modelers? 

Of course, the other half of the title indicates needed coordination between modelers like Gail and monitors like Guoyan Zhang, MD, MPH and Anthony Llau, MPH, PhDc  who monitored ILI for Miami-Dade County in Florida. Daily school absenteeism surveillance used in coordination with evolving models of transmission could improve analysis of the absenteeism data. This is especially important since, as the presenters mention, absenteeism may not always equal true illness (or illness at all).

To learn more about flu and school absenteeism surveillance, and the modeling that can aid in analysis and intervention decisions, be sure to watch the full webinar from October 18, 2011 on our website.


This post is part of the series Fridays from the Archives. You can access all posts in the series here.


Written by Becky Zwickl, MPH, ISDS Public Health Analyst (bzwickl@syndromic.org)

Participate in the 2014 Student Research Paper Contest

Preventing Chronic Disease (PCD) is looking for graduate and undergraduate students to submit papers relevant to the prevention, screening, surveillance, and/or population-based intervention of chronic diseases, including but not limited to arthritis, asthma, cancer, depression, diabetes, obesity, and cardiovascular disease. A peer-reviewed electronic journal, PCD was established to provide a forum for researchers and practitioners in chronic disease prevention and health promotion. The journal is published weekly by the Centers for Disease Control and Prevention’s National Center for Chronic Disease Prevention and Health Promotion.

The winning manuscript will be recognized on the PCD website and will be published in a 2014 PCD release. Papers must be received electronically no later than 5:00 PM EST on January 23, 2014. More information on the contest and the submission process is available here.

Fridays from the Archives: Smart Phones

Friday, January 10, 2014: Smart Phones

At the 2013 ISDS Conference in New Orleans in December we learned about innovative surveillance methods used across the globe. As technology evolves, so too does the ability to improve surveillance strategy and technique.

The Boston University School of Public Health Electronic Data Capture Team worked on integrating existing technologies in new ways, mainly focusing internationally. In 2011 three members of the team, Marion McNabb, MPH, Laura Khurana (then MPH candidate) and Chris Gill, MD, MS presented on their work in Data Collection, Management, and Surveillance: Using Smart Phones in Smart Ways.

Data from smart phones have a number of advantages including accessibility and ease of transmission and receipt. Though some technologies see sudden surges with equally sudden declines in use, cellphone use in general is still rapidly increasing worldwide. As of 2011, phones had been successfully used in surveillance for a number of uses including: Dengue Fever monitoring in Mexico; Real-time outbreak monitoring in mass gatherings, such as the 2009 Hajj; and infectious disease reporting after an earthquake in China (additional details on slide #36 of presentation).

With a number of disparate uses, smart phone surveillance can work with traditional surveillance methods, as well as in place of them. In low resource settings this combination is particularly useful.

This post is part of the series Fridays from the Archives. You can access all posts in the series here.


Written by Becky Zwickl, MPH, ISDS Public Health Analyst (bzwickl@syndromic.org)

2013 ISDS Conference Poster Award Winner

Congratulations to Jessica Sell - the winner of the 2013 ISDS Conference Poster Award. Her poster, 'Evaluating a seasonal ARIMA model for event detection in New York City' was selected based on aesthetics and content.

Jessica Sell is an analyst in the Syndromic Surveillance Unit within the Bureau of Communicable Disease at the New York City Department of Health and Mental Hygiene.

To view the abstract and/or poster, please click here.