Overview of the Information Systems Currently Available to Public Health Researchers   David Walker National Immunization ...
<ul><li>Availability of data for public health monitoring or research is increasing </li></ul><ul><li>Related data may exi...
<ul><li>Defining “Surveillance” in Epidemiological Terms </li></ul><ul><li>Issues in identifying data sources </li></ul><u...
<ul><li>“ The systematic collection of data pertaining to the occurrence of specific diseases, the analysis and interpreta...
<ul><li>Surveillance of specific diseases </li></ul><ul><li>Based on public health monitoring or analysis needs </li></ul>...
Inventory of CDC Surveillance Systems <ul><li>1. 122 Cities Mortality Reporting System  </li></ul><ul><li>2. Active Bacter...
Inventory of CDC Surveillance Systems <ul><li>16. Counseling and Testing System </li></ul><ul><li>17. Creutzfeldt-Jakob Di...
Inventory of CDC Surveillance Systems <ul><li>31. Longitudinal Follow-up to National Maternal and Infant Health Survey </l...
Inventory of CDC Surveillance Systems <ul><li>46. National Electronic Injury Surveillance System </li></ul><ul><li>47. Nat...
Inventory of CDC Surveillance Systems <ul><li>61. National Occupational Mortality Surveillance System </li></ul><ul><li>62...
Inventory of CDC Surveillance Systems <ul><li>76. National Vital Statistics System - Mortality </li></ul><ul><li>77. Natio...
Inventory of CDC Surveillance Systems <ul><li>91. Sentinel Event Notification System for Occupational Risks - Asthma </li>...
Inventory of CDC Surveillance Systems <ul><li>106. Surveillance for Pneumocystis Carinii Pneumonia Treatment Failures </li...
<ul><li>Intent of data collection for purpose other than for epidemiological surveillance </li></ul><ul><li>May cover a br...
<ul><li>Data collected for specific disease or health issue </li></ul><ul><li>Formal sampling protocols employed </li></ul...
<ul><li>Health issue may be more broad or general in nature </li></ul><ul><li>Responders may be self-selected, not sampled...
<ul><li>State-mandated requirements for disease surveillance </li></ul><ul><li>State and Federal monitoring of potential o...
Nationally Notifiable Infectious Diseases  United States, 2002 <ul><li>Aids  </li></ul><ul><li>Anthrax  </li></ul><ul><li>...
Nationally Notifiable Infectious Diseases  United States, 2002, Continued <ul><li>Listeriosis  </li></ul><ul><li>Lyme dise...
<ul><li>National Electronic Telecommunication Surveillance System (NETSS) </li></ul><ul><li>National Electronic Disease Su...
<ul><li>Weekly reporting from States to CDC </li></ul><ul><li>Provides data for Morbidity and Mortality Weekly Report (MMW...
<ul><li>National Vital Statistics System </li></ul><ul><li>Birth and Death certificates filed in states reported to NCHS <...
<ul><li>Basic demographic data on child and parents </li></ul><ul><ul><li>Name, Age, Race, Residential information, etc. <...
<ul><li>Basic demographic data on decedent </li></ul><ul><ul><li>Name, age, race, occupation, etc. </li></ul></ul><ul><li>...
<ul><li>On-going or annual surveys </li></ul><ul><li>General surveys </li></ul><ul><ul><li>National Health Interview Surve...
<ul><li>National Health Interview Survey (NHIS) </li></ul><ul><li>National Immunization Survey (NIS) </li></ul><ul><li>Nat...
<ul><li>National Natality Survey </li></ul><ul><li>National Fetal Mortality Survey </li></ul><ul><li>National Electronic I...
<ul><li>122 Cities Mortality Reporting System </li></ul><ul><li>National Hospital Discharge Survey </li></ul><ul><li>Natio...
<ul><li>Voluntary reporting </li></ul><ul><li>Different individuals may report same incident </li></ul><ul><ul><li>Patient...
<ul><li>Adverse Event Reporting System (AERS) </li></ul><ul><ul><li>Reports of suspected adverse events to pharmaceutical ...
<ul><li>Health data collected by health service provider </li></ul><ul><ul><li>Can be population-specific  </li></ul></ul>...
<ul><li>Medicare and Medicaid Systems </li></ul><ul><li>Veterans Administration data system </li></ul><ul><li>Vaccine Safe...
<ul><li>Chronic disease registries </li></ul><ul><ul><li>Cancer Surveillance, Epidemiology and End Results (SEER)  </li></...
<ul><li>Laboratory reporting systems </li></ul><ul><li>Vaccine Management System (VACMAN) </li></ul><ul><ul><li>Vaccines f...
<ul><li>Data captured by commercial or industrial entities </li></ul><ul><li>May not be patient-specific </li></ul><ul><li...
<ul><li>Over-the-counter drug sales from pharmacy or grocery chains </li></ul><ul><li>Emergency response systems (911 call...
<ul><li>Provides more thorough information about health events </li></ul><ul><li>Must be planned at an appropriate level f...
<ul><li>CDC Information Systems Integration Project </li></ul><ul><ul><li>Integrating notifiable disease reporting systems...
<ul><li>“ Epidemiological Surveillance” has expanded beyond it’s traditional roots </li></ul><ul><li>General characteristi...
Statement regarding Integration
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Textile Plant Vaccination Records

  1. 1. Overview of the Information Systems Currently Available to Public Health Researchers David Walker National Immunization Program [email_address] (404)630-1882 DIMACS Working Group October 16, 2002
  2. 2. <ul><li>Availability of data for public health monitoring or research is increasing </li></ul><ul><li>Related data may exist in multiple sources </li></ul><ul><li>Design of data source can influence applicability to specific studies </li></ul><ul><li>This presentation will provide: </li></ul><ul><ul><li>Basic description of epidemiological surveillance system issues </li></ul></ul><ul><ul><li>General review of CDC data sources </li></ul></ul><ul><ul><li>Example of integrating information sources </li></ul></ul>Background and Objectives
  3. 3. <ul><li>Defining “Surveillance” in Epidemiological Terms </li></ul><ul><li>Issues in identifying data sources </li></ul><ul><ul><li>Surveillance-specific vs. Administrative data sources </li></ul></ul><ul><ul><li>Active vs. Passive Surveillance </li></ul></ul><ul><li>Examples of data sources </li></ul><ul><ul><li>“ Notifiable” health incident reporting </li></ul></ul><ul><ul><li>Spontaneous health incident reporting </li></ul></ul><ul><ul><li>Standard health-related surveys </li></ul></ul><ul><ul><li>Administrative data systems </li></ul></ul><ul><ul><li>Commercial entities </li></ul></ul><ul><li>Integration of Data Sources </li></ul><ul><li>Summary </li></ul>Presentation Overview
  4. 4. <ul><li>“ The systematic collection of data pertaining to the occurrence of specific diseases, the analysis and interpretation of these data, and the dissemination of consolidated and processed information to contributors to the program and other interested persons.” </li></ul><ul><li>Raska, K. 1966. “National and international surveillance in the control of infectious diseases.” WHO Chronicles. 20:313-321 </li></ul>Epidemiological Surveillance Systems
  5. 5. <ul><li>Surveillance of specific diseases </li></ul><ul><li>Based on public health monitoring or analysis needs </li></ul><ul><li>Data collected through public health entities </li></ul><ul><li>Detailed definition of data elements, population sampling methods, and survey administration </li></ul><ul><li>Often designed to allow patient follow-up </li></ul>Traditional Epidemiological Surveillance
  6. 6. Inventory of CDC Surveillance Systems <ul><li>1. 122 Cities Mortality Reporting System </li></ul><ul><li>2. Active Bacterial Core Surveillance </li></ul><ul><li>3. Active Surveillance for Cryptosporidium and Cyclospora via FoodNet </li></ul><ul><li>4. Adult Blood-Lead Epidemiology and Surveillance Program </li></ul><ul><li>5. Adult Spectrum (HIV) of Disease </li></ul><ul><li>6. American Red Cross Health Impact Surveillance System for Natural Disasters </li></ul><ul><li>7. Behavioral Risk Factor Surveillance System </li></ul><ul><li>8. Blood Donor Study </li></ul><ul><li>9. CDC Firearm Injury Surveillance Study </li></ul><ul><li>10. Central Nervous System Injury Surveillance System </li></ul><ul><li>11. Childhood Blood-Lead Poisoning Surveillance System </li></ul><ul><li>12. Cholera </li></ul><ul><li>13. Cholera and Other Vibrio Infections Surveillance System </li></ul><ul><li>14. Clinic-based Blinded HIV Seroprevalence Study </li></ul><ul><li>15. Coal Workers' X-Ray Surveillance Program </li></ul>
  7. 7. Inventory of CDC Surveillance Systems <ul><li>16. Counseling and Testing System </li></ul><ul><li>17. Creutzfeldt-Jakob Disease Surveillance System </li></ul><ul><li>18. Diphtheria Antitoxin </li></ul><ul><li>19. Enterovirus Surveillance System </li></ul><ul><li>20. Fatality Assessment and Control Evaluation </li></ul><ul><li>21. Foodborne Diseases Active Surveillance System </li></ul><ul><li>22. HIV/AIDS Reporting System </li></ul><ul><li>23. Haemophilus Influenzae Surveillance System </li></ul><ul><li>24. Hazardous Substances Emergency Events Surveillance </li></ul><ul><li>25. Hazardous Waste Workers Surveillance Project </li></ul><ul><li>26. Hearing Conservation and Audiometric Database Analysis System </li></ul><ul><li>27. Hemophilia Surveillance System </li></ul><ul><li>28. Imported Dengue </li></ul><ul><li>29. Jail STD Prevalence Monitoring Project </li></ul><ul><li>30. Laboratory Surveillance of Cryptosporidium and Malaria via PHLIS </li></ul>
  8. 8. Inventory of CDC Surveillance Systems <ul><li>31. Longitudinal Follow-up to National Maternal and Infant Health Survey </li></ul><ul><li>32. Lyme Disease - NETSS </li></ul><ul><li>33. Medical Examiner/Coroner Information Sharing Program </li></ul><ul><li>34. Metropolitan Atlanta Congenital Defects Program </li></ul><ul><li>35. Metropolitan Atlanta Developmental Disabilities Surveillance Program </li></ul><ul><li>36. Minimal Data Set for Hemophilia </li></ul><ul><li>37. National Breast/Cervical Cancer Early Detection </li></ul><ul><li>38. NHANES I Epidemiologic Follow-up Study </li></ul><ul><li>39. National Ambulatory Medical Care Survey </li></ul><ul><li>40. National Antimicrobial Surveillance System </li></ul><ul><li>41. National Bacterial Meningitis Reporting System </li></ul><ul><li>42. National Botulism Surveillance System </li></ul><ul><li>43. National Campylobacter Surveillance System </li></ul><ul><li>44. National Coal Workers' Autopsy Study </li></ul><ul><li>45. National Congenital Rubella Syndrome Registry </li></ul>
  9. 9. Inventory of CDC Surveillance Systems <ul><li>46. National Electronic Injury Surveillance System </li></ul><ul><li>47. National Electronic Telecommunications System for Surveillance </li></ul><ul><li>48. National Employer Health Insurance Survey </li></ul><ul><li>49. National Exposure Registry </li></ul><ul><li>50. National Health and Nutrition Examination Survey </li></ul><ul><li>51. National Home and Hospice Care Survey </li></ul><ul><li>52. National Hospital Ambulatory Medical Care Survey </li></ul><ul><li>53. National Hospital Discharge Survey </li></ul><ul><li>54. National Immunization Provider Record Check Study </li></ul><ul><li>55. National Immunization Survey </li></ul><ul><li>56. National Kawasaki Syndrome Surveillance System </li></ul><ul><li>57. National Malaria Surveillance System </li></ul><ul><li>58. National Mortality Follow-back Study </li></ul><ul><li>59. National Nosocomial Infections Surveillance System </li></ul><ul><li>60. National Nursing Home Survey </li></ul>
  10. 10. Inventory of CDC Surveillance Systems <ul><li>61. National Occupational Mortality Surveillance System </li></ul><ul><li>62. National Polio Surveillance System </li></ul><ul><li>63. National Reye Syndrome Surveillance System </li></ul><ul><li>64. National Salmonella Surveillance System </li></ul><ul><li>65. National Surveillance System for Hospital Health Care Workers </li></ul><ul><li>66. National Surveillance System for Pneumoconiosis Mortality </li></ul><ul><li>67. National Surveillance for Domestic Arboviral Encephalitis Cases in Humans </li></ul><ul><li>68. National Surveillance of Dialysis-Associated Diseases in U.S. </li></ul><ul><li>69. National Survey of Ambulatory Surgery </li></ul><ul><li>70. National Survey of Family Growth </li></ul><ul><li>71. National Traumatic Occupational Fatalities Surveillance System </li></ul><ul><li>72. National Tuberculosis Surveillance System </li></ul><ul><li>73. National Vital Statistics System </li></ul><ul><li>74. National Vital Statistics System - Fetal Death </li></ul><ul><li>75. National Vital Statistics System - Linked Birth/Infant Death </li></ul>
  11. 11. Inventory of CDC Surveillance Systems <ul><li>76. National Vital Statistics System - Mortality </li></ul><ul><li>77. National Vital Statistics System - Natality </li></ul><ul><li>78. Nonhuman Primate Retrovirus Infections Among Workers </li></ul><ul><li>79. Parasitic Diseases Drug Service </li></ul><ul><li>80. Pediatric Nutrition Surveillance System </li></ul><ul><li>81. Pediatric Spectrum (HIV) of Disease </li></ul><ul><li>82. Perinatal Hepatitis B Prevention Data Management System </li></ul><ul><li>83. Pertussis </li></ul><ul><li>84. Plague </li></ul><ul><li>85. Pregnancy Nutrition Surveillance System </li></ul><ul><li>86. Pregnancy Risk Assessment Monitoring System </li></ul><ul><li>87. Public Health Laboratory Health Information System </li></ul><ul><li>88. Regional Infertility Prevention Program - Chlamydia </li></ul><ul><li>89. Second Longitudinal Study on Aging </li></ul><ul><li>Sentinel Counties Study of Viral Hepatitis </li></ul>
  12. 12. Inventory of CDC Surveillance Systems <ul><li>91. Sentinel Event Notification System for Occupational Risks - Asthma </li></ul><ul><li>92. Sentinel Event Notification System for Occupational Risks - Pesticides </li></ul><ul><li>93. Sentinel Event Notification System for Occupational Risks - Silicosis </li></ul><ul><li>94. Sentinel Site Laboratory-Based Surveillance for Cyclospora </li></ul><ul><li>95. Sexually Transmitted Disease Surveillance System (Form CDC-73.126) </li></ul><ul><li>96. Sexually Transmitted Disease Surveillance System (Form CDC-73.60A) </li></ul><ul><li>97. Sexually Transmitted Disease Surveillance System (Form CDC-73.998) </li></ul><ul><li>98. Sexually Transmitted Disease Surveillance System (Form CDC-9.2638) </li></ul><ul><li>99. Sexually Transmitted Disease Surveillance System (Form CDC-9.688) </li></ul><ul><li>100. Sexually Transmitted Diseases Management Information System </li></ul><ul><li>101. Shigella </li></ul><ul><li>102. State-Based Emergency Department Injury Surveillance </li></ul><ul><li>103. Streptococcus Pneumoniae and Haemophilus Influenzae </li></ul><ul><li>104. Supplement to HIV/AIDS Surveillance </li></ul><ul><li>105. Surveillance for Giardia </li></ul>
  13. 13. Inventory of CDC Surveillance Systems <ul><li>106. Surveillance for Pneumocystis Carinii Pneumonia Treatment Failures </li></ul><ul><li>107. Surveillance for Trichinosis and Cryptosporidium </li></ul><ul><li>108. Tetanus </li></ul><ul><li>109. Tickborne Relapsing Fever and Tularemia </li></ul><ul><li>110. Tuberculosis Infection in Health Care Workers </li></ul><ul><li>111. Tuberculosis Information Management System </li></ul><ul><li>112. U.S. Influenza Sentinel Physician Surveillance Network </li></ul><ul><li>113. Unexplained Deaths and Serious Illnesses Surveillance </li></ul><ul><li>114. Universal Data Collection and Serum Specimen Collection System </li></ul><ul><li>115. Vaccine Adverse Event Reporting System </li></ul><ul><li>116. Vaccine Safety Datalink Project </li></ul><ul><li>117. Viral Hepatitis Surveillance Program </li></ul><ul><li>118. Waterborne Diseases Outbreak Surveillance System </li></ul><ul><li>119. Young Men's Survey </li></ul><ul><li>120. Youth Risk Behavior Surveillance System </li></ul>
  14. 14. <ul><li>Intent of data collection for purpose other than for epidemiological surveillance </li></ul><ul><li>May cover a broad range of health issues </li></ul><ul><li>May not be patient specific </li></ul><ul><li>Data structure may not conform to public health-related data standards </li></ul><ul><li>May not have population sampling concerns </li></ul>Administrative Health Data Sources
  15. 15. <ul><li>Data collected for specific disease or health issue </li></ul><ul><li>Formal sampling protocols employed </li></ul><ul><li>Usually a specific time frame for administering surveys </li></ul><ul><li>Typically conducted by trained public health professionals </li></ul>Active Surveillance Design
  16. 16. <ul><li>Health issue may be more broad or general in nature </li></ul><ul><li>Responders may be self-selected, not sampled </li></ul><ul><li>Data collection may be on-going without discrete intervals </li></ul><ul><li>Data may be “self-reported” </li></ul>Passive Surveillance Design
  17. 17. <ul><li>State-mandated requirements for disease surveillance </li></ul><ul><li>State and Federal monitoring of potential outbreaks of communicable diseases </li></ul><ul><li>Provides for individual case investigation </li></ul><ul><li>Monitoring of disease spread </li></ul>Notifiable Disease Surveillance Characteristics
  18. 18. Nationally Notifiable Infectious Diseases United States, 2002 <ul><li>Aids </li></ul><ul><li>Anthrax </li></ul><ul><li>Botulism </li></ul><ul><li>Brucellosis </li></ul><ul><li>Chancroid </li></ul><ul><li>Chlamydia </li></ul><ul><li>Cholera </li></ul><ul><li>Coccidioidomycosis </li></ul><ul><li>Cryptosporidiosis </li></ul><ul><li>Cyclosporiasis </li></ul><ul><li>Diphtheria </li></ul><ul><li>Ehrlichiosis </li></ul><ul><li>Encephalitis </li></ul><ul><li>Enterohemorrhagic Escherichia coli </li></ul><ul><li>Giardiasis </li></ul><ul><li>Gonorrhea </li></ul><ul><li>Haemophilus influenzae, invasive disease </li></ul><ul><li>Hansen disease (leprosy) </li></ul><ul><li>Hantavirus pulmonary syndrome </li></ul><ul><li>Hemolytic uremic syndrome </li></ul><ul><li>Hepatitis </li></ul><ul><li>HIV infection </li></ul><ul><li>Legionellosis </li></ul>
  19. 19. Nationally Notifiable Infectious Diseases United States, 2002, Continued <ul><li>Listeriosis </li></ul><ul><li>Lyme disease </li></ul><ul><li>Malaria </li></ul><ul><li>Measles </li></ul><ul><li>Meningococcal disease </li></ul><ul><li>Mumps </li></ul><ul><li>Pertussis </li></ul><ul><li>Plague </li></ul><ul><li>Poliomyelitis, paralytic </li></ul><ul><li>Psittacosis </li></ul><ul><li>Q fever </li></ul><ul><li>Rabies </li></ul><ul><li>Rocky mountain spotted fever </li></ul><ul><li>Rubella </li></ul><ul><li>Rubella, congenital syndrome </li></ul><ul><li>Salmonellosis </li></ul><ul><li>Shigellosis </li></ul><ul><li>Streptococcal diseases </li></ul><ul><li>Syphilis </li></ul><ul><li>Tetanus </li></ul><ul><li>Toxic-shock syndrome </li></ul><ul><li>Trichinosis </li></ul><ul><li>Tuberculosis </li></ul><ul><li>Tularemia </li></ul><ul><li>Typhoid fever </li></ul><ul><li>Varicella (deaths only) </li></ul><ul><li>Yellow fever </li></ul>
  20. 20. <ul><li>National Electronic Telecommunication Surveillance System (NETSS) </li></ul><ul><li>National Electronic Disease Surveillance System (NEDSS, in development) </li></ul><ul><li>HIV/AIDS Reporting System (HARS) </li></ul><ul><li>Sexually Transmitted Disease Management Information System (STDMIS) </li></ul><ul><li>Tuberculosis Information Management System (TIMS) </li></ul>Notifiable Disease Surveillance Examples
  21. 21. <ul><li>Weekly reporting from States to CDC </li></ul><ul><li>Provides data for Morbidity and Mortality Weekly Report (MMWR) </li></ul><ul><li>Includes patient demographic data (core record) </li></ul><ul><li>Includes disease-specific data (extended record) </li></ul><ul><li>Case investigation allows additional data collection and editing </li></ul>NETSS Characteristics
  22. 22. <ul><li>National Vital Statistics System </li></ul><ul><li>Birth and Death certificates filed in states reported to NCHS </li></ul><ul><li>Data standards developed by NCHS, but can vary by state </li></ul><ul><li>NCHS prepares public use data files or reports </li></ul><ul><ul><li>Vital and Health Statistics Series </li></ul></ul><ul><ul><li>National Death Index </li></ul></ul>Vital Statistics Reporting Characteristics
  23. 23. <ul><li>Basic demographic data on child and parents </li></ul><ul><ul><li>Name, Age, Race, Residential information, etc. </li></ul></ul><ul><li>Newborn’s health status </li></ul><ul><ul><li>Weight, gestational age, apgar scores, congenital malformations, birth method, etc. </li></ul></ul><ul><li>Mother’s health status </li></ul><ul><ul><li>Pregnancy status, STD test results, chronic or infectious diseases present, hazardous material exposure, alcohol, tobacco, or drug use during pregnancy, conditions of labor, etc. </li></ul></ul>Vital Statistics Birth Certificate Information
  24. 24. <ul><li>Basic demographic data on decedent </li></ul><ul><ul><li>Name, age, race, occupation, etc. </li></ul></ul><ul><li>Place of death </li></ul><ul><ul><li>City, county, hospital, etc. </li></ul></ul><ul><li>Cause of Death </li></ul><ul><ul><li>Immediate cause, contributing causes, length of illness, etc. </li></ul></ul><ul><li>Disposition of body </li></ul><ul><ul><li>Autopsy performed, cremation, location of burial, etc. </li></ul></ul>Vital Statistics Death Certificate Information
  25. 25. <ul><li>On-going or annual surveys </li></ul><ul><li>General surveys </li></ul><ul><ul><li>National Health Interview Survey </li></ul></ul><ul><ul><li>Complex sampling protocols </li></ul></ul><ul><li>Specific to particular health issue </li></ul><ul><ul><li>National Fetal Death Mortality Survey </li></ul></ul><ul><ul><li>Follow-up on specific health incidents </li></ul></ul><ul><li>Monitor specific health provider services </li></ul><ul><ul><li>U.S. Influenza Sentinel Physician Surveillance Network </li></ul></ul>National Health-Related Surveys Characteristics
  26. 26. <ul><li>National Health Interview Survey (NHIS) </li></ul><ul><li>National Immunization Survey (NIS) </li></ul><ul><li>National Health and Nutrition Examination Survey (NHANES) </li></ul><ul><li>Behavioral Risk Factor Surveillance System (BRFSS) </li></ul>National Health-Related Surveys Examples of General Surveys
  27. 27. <ul><li>National Natality Survey </li></ul><ul><li>National Fetal Mortality Survey </li></ul><ul><li>National Electronic Injury Surveillance System </li></ul><ul><li>Birth Defects Monitoring Program </li></ul>National Health-Related Surveys Examples of Health Issue-Specific Surveys
  28. 28. <ul><li>122 Cities Mortality Reporting System </li></ul><ul><li>National Hospital Discharge Survey </li></ul><ul><li>National Ambulatory Medical Care Survey </li></ul><ul><li>National Nursing Home Survey </li></ul>National Health-Related Surveys Examples of Health Provider Surveys
  29. 29. <ul><li>Voluntary reporting </li></ul><ul><li>Different individuals may report same incident </li></ul><ul><ul><li>Patient, physician, family member, etc. </li></ul></ul><ul><li>Multiple records for same incident may contain different data </li></ul><ul><li>Subsequent events for the same individual may not be linked </li></ul><ul><li>Rates difficult to calculate due to lack of denominator data </li></ul>Spontaneous Surveillance Systems Characteristics
  30. 30. <ul><li>Adverse Event Reporting System (AERS) </li></ul><ul><ul><li>Reports of suspected adverse events to pharmaceutical products </li></ul></ul><ul><li>Vaccine Adverse Event Reporting System (VAERS) </li></ul>Spontaneous Surveillance Systems Examples
  31. 31. <ul><li>Health data collected by health service provider </li></ul><ul><ul><li>Can be population-specific </li></ul></ul><ul><li>Administrative purposes for data </li></ul><ul><ul><li>Enrollment, patient registry, billing, case management, procedure results </li></ul></ul><ul><li>May link to external data sources </li></ul><ul><li>Rarely study-specific data </li></ul><ul><li>Subject to anomalies of administrative system </li></ul><ul><ul><li>“ Upcoding” diagnoses, inclusion of “rule out” codes, etc. </li></ul></ul>Administrative Data Systems Characteristics
  32. 32. <ul><li>Medicare and Medicaid Systems </li></ul><ul><li>Veterans Administration data system </li></ul><ul><li>Vaccine Safety DataLink </li></ul><ul><ul><li>HMO data for pharmacoepidemiology </li></ul></ul>Administrative Data Systems Health Provider Examples
  33. 33. <ul><li>Chronic disease registries </li></ul><ul><ul><li>Cancer Surveillance, Epidemiology and End Results (SEER) </li></ul></ul><ul><ul><li>National Congenital Rubella Syndrome Registry </li></ul></ul><ul><li>Vaccine registries </li></ul>Administrative Data Systems Registry Examples
  34. 34. <ul><li>Laboratory reporting systems </li></ul><ul><li>Vaccine Management System (VACMAN) </li></ul><ul><ul><li>Vaccines for Children grant ordering system </li></ul></ul><ul><li>Insurance company claims processing </li></ul><ul><li>Industrial employees records </li></ul><ul><ul><li>Ford Motor Company </li></ul></ul><ul><ul><li>Textile plant vaccination records </li></ul></ul>Administrative Data Systems Other Examples
  35. 35. <ul><li>Data captured by commercial or industrial entities </li></ul><ul><li>May not be patient-specific </li></ul><ul><li>Data may not be complete </li></ul><ul><li>Data quality may be suspect </li></ul>Other Health Data Sources Characteristics
  36. 36. <ul><li>Over-the-counter drug sales from pharmacy or grocery chains </li></ul><ul><li>Emergency response systems (911 calls) </li></ul><ul><li>Web logs of health-related entities </li></ul><ul><li>Media monitoring services </li></ul>Other Health-Related Data Sources Examples
  37. 37. <ul><li>Provides more thorough information about health events </li></ul><ul><li>Must be planned at an appropriate level for the granularity of the data </li></ul><ul><li>Integration at the patient-specific level </li></ul><ul><ul><li>Matching lab reports with notifiable disease reports </li></ul></ul><ul><li>Integration at a more general level </li></ul><ul><ul><li>Linking patient residence to Census Block data </li></ul></ul><ul><li>Integration at a summary level </li></ul><ul><ul><li>Linking county or state summary </li></ul></ul><ul><ul><li>characteristics </li></ul></ul>Integration of Data Sources
  38. 38. <ul><li>CDC Information Systems Integration Project </li></ul><ul><ul><li>Integrating notifiable disease reporting systems, laboratory reporting systems, and disease registry systems </li></ul></ul><ul><li>Match Medicaid data with VA Hospital data </li></ul><ul><ul><li>Provides more complete source of elderly patient data </li></ul></ul><ul><li>Link patient data to Census Block data </li></ul><ul><ul><li>Provides demographic characteristics missing from patient data </li></ul></ul>Integration of Data Sources Examples
  39. 39. <ul><li>“ Epidemiological Surveillance” has expanded beyond it’s traditional roots </li></ul><ul><li>General characteristics of surveillance data sources </li></ul><ul><ul><li>Surveillance can be active or passive </li></ul></ul><ul><ul><li>Administrative data sources can provide surveillance data </li></ul></ul><ul><li>Examples of data sources </li></ul><ul><ul><li>Notifiable disease reporting </li></ul></ul><ul><ul><li>Spontaneous health incident reporting </li></ul></ul><ul><ul><li>National health-related surveys </li></ul></ul><ul><ul><li>Administrative data systems </li></ul></ul><ul><ul><li>Commercial entities </li></ul></ul><ul><li>Integration of Data Sources </li></ul>Summary
  40. 40. Statement regarding Integration
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