BiosurveillanceCore Information Needs for Situational

Awareness and Response

6 November 2013

What is biosurveillance?

Definition

Biosurveillance. The collection, management and integration of health-related data for the purpose of improving detection, characterization, prevention and management of health hazards.

What type of health-related datado you need?

Before, during and after a hurricane …

Before, during and after a mass gathering, such as a National Convention or the Boston

Marathon …

Or if an unknown outbreak or pandemic occurs, or zombies attack …

The point is

Public health leaders need information systems in place to capture and gather data that will inform the decisions they make.

Intro to Biosurveillance

When it works, biosurveillance provides decision-makers with information to help with:- Early warning and detection of health threats- Situational awareness- Consequence management

How data are gathered and monitored

A current challenge of a national, or even local, biosurveillance approach is integrating and managing health-related data gathered through various information systems.

Systems used to gather data

Examples of information systems include:- NC EDSS & NC DETECT in North Carolina- ESSENCE in the National Capital Region- ED-based in New York City- SendSS in Georgia

Other challenges

- Interoperability between systems- Information systems vary state to state- Epidemiological and technical capabilities vary

within health departments- Systems that are flexible enough to meet

information needs during an event

Core Information

- The type of data leaders have is important.- Public health leaders need core information,

including health status, health risks and health services to support decision-making during a public health threat.

Core Information Qualities

In addition, these data should be:- Useful- Timely- Accessible

As well as provide detail on:- Sensitivity- Specificity- Predictive value

Core Information Sources

1. Electronic Lab Reporting2. Emergency Department Reporting3. Electronic Disease Surveillance Systems4. Health System Utilization Information

It is important to remember there are a wide range of additional information sources that may prove useful to decision-makers.

DecisionPoint

Framing public information messages to help people stay safe.

Decision Point

Using ED data to track patient information and system access.

Decision PointWhen to prioritize populations and how to allocate

resources during times of scarce supply.

Getting to Situational Awareness

In an ideal world, biosurveillance systems:1. Collect core information, pertinent to health status,

risk and resources2. Gather information that is useful, timely and

accessible3. Integrate and analyze data from a variety of

information sources

Guiding Principles

1. Biosurveillance systems should be used everyday, not just during a response.

2. These systems require ongoing investment and support.

3. Must be designed to support workflow at all levels.

4. A formal business process analysis can help guide design and development.

Guiding Principles

5. Systems should comply with applicable messaging and data standards in order to be scalable and operable.

6. Systems should be flexible and able to adapt to the context of an event.

7. Public health agencies should be adequately staffed and resourced to design, manage and optimize core information system capabilities.

More Information

Final report, submitted by UNC and PHII to CDC September 2013

Improving Public Health Preparedness: Strengthening Biosurveillance Systems for

Enhanced Situational Awareness

Next: Providing Assistance to States

- Create a peer assistance network to share best practices and lessons learned across jurisdictions.

- Create a knowledge repository of best practices in biosurveillance for major national events.

- Provide opportunities for CDC grantees to engage and learn more from experts on how to continuously improve their biosurveillance systems.

Discussion

Contact Info

Jessica Southwell, MPHResearch Associate

NC Institute for Public Health UNC Gillings School of Global Public Health

jessica.southwell@unc.edu