scholarly journals Public health reporting and outbreak response: synergies with evolving clinical standards for interoperability

2020 ◽  
Vol 27 (7) ◽  
pp. 1136-1138 ◽  
Author(s):  
Ninad K Mishra ◽  
Jon Duke ◽  
Leslie Lenert ◽  
Saugat Karki
Keyword(s):  
Public Health ◽  
Fast Moving ◽  
Disease Surveillance ◽  
Health Workers ◽  
Clinical Information ◽  
Patient Privacy ◽  
Outbreak Response ◽  
Healthcare Resources ◽  
Public Health Reporting ◽  
Application Programming

Abstract Public health needs up-to-date information for surveillance and response. As healthcare application programming interfaces become widely available, a novel data gathering mechanism could provide public health with critical information in a timely fashion to respond to a fast-moving epidemic. In this article, we extrapolate from our experiences using a Fast Healthcare Interoperability Resource-based architecture for infectious disease surveillance for sexually transmitted diseases to its application to gather case information for an outbreak. One of the challenges with a fast-moving outbreak is to accurately assess its demand on healthcare resources, since information specific to comorbidities is often not available. These comorbidities are often associated with poor prognosis and higher resource utilization. If the comorbidity data and other clinical information were readily available to public health workers, they could better address community disruption and manage healthcare resources. The use of FHIR resources available through application programming and filtered through tools such as described herein will give public health the flexibility needed to investigate rapidly emerging disease while protecting patient privacy.

Information systems in support of public health in high-income countries

2021 ◽  
pp. 3-12
Author(s):  
Tjeerd-Pieter van Staa ◽  
Liam Smeeth
Keyword(s):  
Public Health ◽  
Information Systems ◽  
Disease Surveillance ◽  
Point Of Care ◽  
Clinical Care ◽  
Healthcare Providers ◽  
Clinical Information ◽  
Evidence Base ◽  
Healthcare Intervention ◽  
Healthcare Interventions

Public health activities are dependent on the availability of information and ability to disseminate information to clinicians/healthcare providers, individuals, and communities. The increasing computerization of healthcare systems can offer opportunities to improve these activities. Databases of electronic healthcare records are used for disease surveillance and monitoring healthcare interventions. The quality and quantity of reporting of notifiable diseases may be improved by regular review of the electronic healthcare records. Randomized trials that recruit patients at the point of care and use electronic healthcare records for collection of follow-up information can be used to test the effectiveness of healthcare intervention in routine clinical practice. Cluster trials that randomize different clinics or regions can compare different public health policies and improve the evidence base for the pragmatic use of public health interventions. Data generated within clinical information systems can be used to provide feedback and guidance to clinicians and patients as part of clinical care. Better information systems providing data on risks and benefits of healthcare interventions will provide an important impetus to evidence-based public health.

scholarly journals Phylogenomic Pipeline Validation for Foodborne Pathogen Disease Surveillance

2019 ◽  
Vol 57 (5) ◽  
Author(s):  
Ruth E. Timme ◽  
Errol Strain ◽  
Joseph D. Baugher ◽  
Steven Davis ◽  
Narjol Gonzalez-Escalona ◽  
...  
Keyword(s):  
Public Health ◽  
Disease Surveillance ◽  
Foodborne Pathogen ◽  
The United States ◽  
Strain Identification ◽  
Outbreak Response ◽  
Entire Genome ◽  
Public Health Agencies ◽  
Regulatory Decision ◽  
Health Agencies

ABSTRACT Foodborne pathogen surveillance in the United States is transitioning from strain identification using restriction digest technology (pulsed-field gel electrophoresis [PFGE]) to shotgun sequencing of the entire genome (whole-genome sequencing [WGS]). WGS requires a new suite of analysis tools, some of which have long histories in academia but are new to the field of public health and regulatory decision making. Although the general workflow is fairly standard for collecting and analyzing WGS data for disease surveillance, there are a number of differences in how the data are collected and analyzed across public health agencies, both nationally and internationally. This impedes collaborative public health efforts, so national and international efforts are underway to enable direct comparison of these different analysis methods. Ultimately, the harmonization efforts will allow the (mutually trusted and understood) production and analysis of WGS data by labs and agencies worldwide, thus improving outbreak response capabilities globally. This review provides a historical perspective on the use of WGS for pathogen tracking and summarizes the efforts underway to ensure the major steps in phylogenomic pipelines used for pathogen disease surveillance can be readily validated. The tools for doing this will ensure that the results produced are sound, reproducible, and comparable across different analytic approaches.

scholarly journals The Surveillance Outbreak Response Management and Analysis System (SORMAS): Digital Health Global Goods Maturity Assessment (Preprint)

2019 ◽  
Author(s):  
Daniel Tom-Aba ◽  
Bernard Chawo Silenou ◽  
Juliane Doerrbecker ◽  
Carl Fourie ◽  
Carl Leitner ◽  
...  
Keyword(s):  
Disease Surveillance ◽  
Web Application ◽  
Health Workers ◽  
Digital Health ◽  
Community Support ◽  
Management Tool ◽  
Maturity Model ◽  
Outbreak Response ◽  
Health Community ◽  
Analysis System

BACKGROUND Digital health is a dynamic field that has been generating a large number of tools; many of these tools do not have the level of maturity required to function in a sustainable model. It is in this context that the concept of global goods maturity is gaining importance. Digital Square developed a global good maturity model (GGMM) for digital health tools, which engages the digital health community to identify areas of investment for global goods. The Surveillance Outbreak Response Management and Analysis System (SORMAS) is an open-source mobile and web application software that we developed to enable health workers to notify health departments about new cases of epidemic-prone diseases, detect outbreaks, and simultaneously manage outbreak response. OBJECTIVE The objective of this study was to evaluate the maturity of SORMAS using Digital Square’s GGMM and to describe the applicability of the GGMM on the use case of SORMAS and identify opportunities for system improvements. METHODS We evaluated SORMAS using the GGMM version 1.0 indicators to measure its development. SORMAS was scored based on all the GGMM indicator scores. We described how we used the GGMM to guide the development of SORMAS during the study period. GGMM contains 15 subindicators grouped into the following core indicators: (1) global utility, (2) community support, and (3) software maturity. RESULTS The assessment of SORMAS through the GGMM from November 2017 to October 2019 resulted in full completion of all subscores (10/30, (33%) in 2017; 21/30, (70%) in 2018; and 30/30, (100%) in 2019). SORMAS reached the full score of the GGMM for digital health software tools by accomplishing all 10 points for each of the 3 indicators on global utility, community support, and software maturity. CONCLUSIONS To our knowledge, SORMAS is the first electronic health tool for disease surveillance, and also the first outbreak response management tool, that has achieved a 100% score. Although some conceptual changes would allow for further improvements to the system, the GGMM already has a robust supportive effect on developing software toward global goods maturity.

scholarly journals Implementation of Integrated Disease Surveillance and Response (IDSR) in Swaziland

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Siphiwe M Shongwe-Gama ◽  
Dr. Thulani Maphosa ◽  
Phinda Khumalo ◽  
Vusie Lokotfwako ◽  
Nhlanhla Nhlabatsi ◽  
...  
Keyword(s):  
Public Health ◽  
Disease Surveillance ◽  
Public Health Surveillance ◽  
Health Workers ◽  
Health Surveillance ◽  
Health Facilities ◽  
Health Systems Strengthening ◽  
Notification System ◽  
Surveillance And Response ◽  
And Control

Objective: To strengthen public health surveillance and monitor implementation of Integrated Disease Surveillance and Response in the Kingdom of Swaziland.Introduction: Swaziland adopted the Integrated Disease Surveillance and Response (IDSR) strategy in 2010 to strengthen Public Health Surveillance (PHS) that fulfills International Health Regulations (2005) and the Global Health Security Agenda (GHSA). This strategy allows the Ministry of Health (MoH), Epidemiology and Disease Control Unit (EDCU) to monitor, prevent and control priority diseases in the country. We used a health systems strengthening approach to pilot an intervention model for IDSR implementation at five hospitals in Swaziland over a pilot phase of three months.Methods: Our intervention included cross-country IDSR trainings, sensitizations and onsite trainings targeting national and regional health teams for over 250 health workers. The EDCU developed and disseminated standardized case definitions for health facilities (HFs) to detect, confirm and report priority conditions. Trained health care workers were tasked to cascade knowledge sharing and sensitization about IDSR with their HFs during in-service trainings. The facilities were to use IDSR standard case definition as guidelines for diagnosing and reporting cases; submit monthly reports on all priority conditions to Health Management Information System (HMIS) and intensify reporting through immediate disease notification system (IDNS) for all notifiable conditions. Indicators and monitoring tools for disease surveillance and response as recommended by the technical guidelines for IDSR in the African region were developed. The intervention was evaluated at five purposively selected high-volume referral hospitals (attending to ≥1500 to 15000 outpatient visits per month), which also have maternity services.Structured questionnaires in the form of a monitoring tool, checklists and observations were used to collect data. Quantitatively, monthly reports submitted by the five facilities to HMIS were reviewed and analyzed for completeness and timeliness. Clinic supervisors were identified from outpatient, inpatient, maternity and laboratory departments as key informants to explore successes and challenges of IDSR implementation. Additionally, IDSR officers visited health facilities and observed the registers and reporting forms used to report IDSR priority conditions and the availability of IDSR guidelines.Results: The five HFs submitted monthly reports from June to August 2017 with a calculated completeness of 80% in June 2017, 60% in July and 40% in August. Timeliness was calculated was at 20% in June, 20% in July and 40% in August. IDSR officers observed that all five HFs document cases of priority diseases in registers during consultations and use daily tally sheets. However, it was observed that diseases reported through the immediate diseases notification system were not all documented in the morbidity registers and vice versa. Health workers reported to be unaware about all diseases that require immediate notification to trigger investigation, hence some disease like perinatal deaths were never notified through the IDNS system during the period of evaluation. All five hospitals reported not utilizing the standard cases definitions provided to identify and report IDSR priority diseases.Conclusions: The proportion of completeness and timeliness from the five HFs during the evaluation period was low compared to WHO recommended standards of >= 80% from all HFs. This therefore, poses challenges in monitoring and responding to the priority conditions as per IDSR standards and recommendations. All five hospitals reported not utilizing the standard cases definitions to identify and report IDSR priority diseases and this poses challenges in comparison of data across sites, monitoring priority diseases, conditions and events and also identifying the alert or epidemic thresholds. There is need to capacitate more health workers on IDSR for Swaziland to strengthen PHS and be able to prevent and control public health threats timely.

scholarly journals Infectious Diseases Physicians: Improving and Protecting the Public’s Health: Why Equitable Compensation Is Critical

2018 ◽  
Vol 69 (2) ◽  
pp. 352-356 ◽  
Author(s):  
Matthew Zahn ◽  
Amesh A Adalja ◽  
Paul G Auwaerter ◽  
Paul J Edelson ◽  
Gail R Hansen ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Diseases ◽  
Disease Surveillance ◽  
Active Role ◽  
Policy Recommendations ◽  
Outbreak Response ◽  
Hospital Acquired Infection ◽  
Proven Efficacy ◽  
Hospital Acquired ◽  
Population And Public Health

Abstract Infectious diseases (ID) physicians play a crucial role in public health in a variety of settings. Unfortunately, much of this work is undercompensated despite the proven efficacy of public health interventions such as hospital acquired infection prevention, antimicrobial stewardship, disease surveillance, and outbreak response. The lack of compensation makes it difficult to attract the best and the brightest to the field of ID, threatening the future of the ID workforce. Here, we examine compensation data for ID physicians compared to their value in population and public health settings and suggest policy recommendations to address the pay disparities that exist between cognitive and procedural specialties that prevent more medical students and residents from entering the field. All ID physicians should take an active role in promoting the value of the subspecialty to policymakers and influencers as well as trainees.

scholarly journals PO 8522 ESTABLISHING AN EQUITABLE GOVERNANCE FRAMEWORK FOR AN EBOLA DATA-SHARING PLATFORM

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A49.1-A49
Author(s):  
Mahmoud Sama Cherif ◽  
Elaine Craig ◽  
Samantha Strudwick ◽  
Alice Hawryszkiewycz ◽  
Laura Merson
Keyword(s):  
Public Health ◽  
Health Benefit ◽  
Emerging Infections ◽  
Patient Privacy ◽  
Outbreak Response ◽  
Governance Framework ◽  
Stakeholder Consultation ◽  
Research Communities ◽  
Data Platform ◽  
Academic Recognition

BackgroundDespite the potential public health gains of enabling access to patient-level data on emerging infections, the launch of a centralised, international platform to deliver on this has not been achieved to date. Barriers include: concerns over retention of national data ownership; patient privacy; appropriate consent; loss of academic recognition; criticism or exploitation of the data generators; perceived data misuse; and the challenges of sharing benefits with communities where data is generated.MethodsTo determine the best approach to these issues in the context of Ebola, we have assembled a collaboration of partners including governments of Ebola-affected countries, non-government organisations, academic institutions, funders and public health authorities to form the Steering Committee of the Ebola Data Platform. Following stakeholder consultation, research and debate, the committee has developed a governance framework to enable access to emerging infections data, beginning with the data from the West African Ebola outbreak.ResultsPromoting fair and equitable sharing of benefits that arise from the use of data is a key element of the framework. Strategies to secure this principle include integration of platform data management activities with the national health institutions in Ebola-affected countries and collaboration with research communities in these countries to determine research priorities and plan analyses. Public health benefit in affected countries is further supported via training and strengthening of research capacity and infrastructure.ConclusionDeveloping a governance framework centered on the principle of equity has focused activities of the Ebola Data Platform on the affected health and research communities where they can have the most impact on patient outcomes, public health preparedness and future outbreak response.

scholarly journals Commercially available rapid diagnostic tests for the detection of high priority pathogens: status and challenges

The Analyst ◽  
2021 ◽  
Author(s):  
Jaime Castillo-León ◽  
Ramona Trebbien ◽  
John J. Castillo ◽  
Winnie E. Svendsen
Keyword(s):  
Public Health ◽  
Diagnostic Tests ◽  
Disease Surveillance ◽  
Low Cost ◽  
Rapid Diagnostic Tests ◽  
Health Reporting ◽  
Public Health Reporting ◽  
Resource Limited

Rapid diagnostic tests (RDTs) will provide a key element of disease surveillance. Their rapid turnaround, low cost, and accessibility in resource limited areas will help increase public health reporting and facilitate outbreak containment.

scholarly journals The Surveillance Outbreak Response Management and Analysis System (SORMAS): Digital Health Global Goods Maturity Assessment

10.2196/15860 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e15860 ◽  
Author(s):  
Daniel Tom-Aba ◽  
Bernard Chawo Silenou ◽  
Juliane Doerrbecker ◽  
Carl Fourie ◽  
Carl Leitner ◽  
...  
Keyword(s):  
Disease Surveillance ◽  
Web Application ◽  
Health Workers ◽  
Digital Health ◽  
Community Support ◽  
Management Tool ◽  
Maturity Model ◽  
Outbreak Response ◽  
Health Community ◽  
Analysis System

Background Digital health is a dynamic field that has been generating a large number of tools; many of these tools do not have the level of maturity required to function in a sustainable model. It is in this context that the concept of global goods maturity is gaining importance. Digital Square developed a global good maturity model (GGMM) for digital health tools, which engages the digital health community to identify areas of investment for global goods. The Surveillance Outbreak Response Management and Analysis System (SORMAS) is an open-source mobile and web application software that we developed to enable health workers to notify health departments about new cases of epidemic-prone diseases, detect outbreaks, and simultaneously manage outbreak response. Objective The objective of this study was to evaluate the maturity of SORMAS using Digital Square’s GGMM and to describe the applicability of the GGMM on the use case of SORMAS and identify opportunities for system improvements. Methods We evaluated SORMAS using the GGMM version 1.0 indicators to measure its development. SORMAS was scored based on all the GGMM indicator scores. We described how we used the GGMM to guide the development of SORMAS during the study period. GGMM contains 15 subindicators grouped into the following core indicators: (1) global utility, (2) community support, and (3) software maturity. Results The assessment of SORMAS through the GGMM from November 2017 to October 2019 resulted in full completion of all subscores (10/30, (33%) in 2017; 21/30, (70%) in 2018; and 30/30, (100%) in 2019). SORMAS reached the full score of the GGMM for digital health software tools by accomplishing all 10 points for each of the 3 indicators on global utility, community support, and software maturity. Conclusions To our knowledge, SORMAS is the first electronic health tool for disease surveillance, and also the first outbreak response management tool, that has achieved a 100% score. Although some conceptual changes would allow for further improvements to the system, the GGMM already has a robust supportive effect on developing software toward global goods maturity.

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