Presentation of the 15th NMFP meeting held on 13-14 October 2016 in Stockholm

1. Feedback from the NFP for
Surveillance meeting, 12 October 2016
Bruno Ciancio, SRS
European Centre for Disease Prevention and Control
Stockholm, 13 October 2016

2. 1
Main topics addressed
1. Surveillance system reengineering project (SSR)
2. Status of the LTSS implementation
3. Isolate based reporting
4. Country profiles

3. 2
Aim of SSR
• To address current system’s inefficiencies and technical
weaknesses, to reduce the reporting burden and to
maximise the EU/EEA surveillance benefits for the Member
States

4. 3
Phase A: Target Surveillance Architecture
Defines the business vision, processes, concepts,
information, application, infrastructure
High-level project phases
Phase B: Reengineering roadmap
What components will be reused, build or acquired
Phase C: Roadmap implementation
Planning and roadmap execution
2015/2016
2016
2017 onwards

5. 4
Some numbers
• 5 business functions identified
• 70 processes modelled
• 150 business objects used as in- and outputs.
• 120 blocks of IT functionalities

6. 5
Recommendations from MS (surveillance,
microbiology, threat detection), June 2016
1) Make the surveillance management transparent to data
providers
2) Reduce the surveillance burden
3) Integrate surveillance systems
4) Find ways to promote visibility of national data providers
with their National authorities (MoH)
5) Keep emphasis on data interpretation
6) Monitor use of data from third parties
7) Strengthen visualisation tools especially for event based
surveillance

7. 6
Main feedback on SSR NFP Surveillance 12
October
1. Collaborative platform (MyECDC) giving access to all
surveillance applications and processes
2. Notification system embedded in MyECDC
3. ECDC giving access to external data sources and
interagency databases, including analysis guidelines
4. Facilitate easy upload of frequently reported diseases
(machine to machine, laboratory based, cases instead of
files)
5. Make the data access from third parties transparent (list of
requests, requesters, data)
6. Prioritise EPIS, communication platforms, and solutions for
frequent uploading of data
7. Keep MS informed on SSR through extranet and newsletter

8. 7
Application modelling – IT functions
Next step (starting now)
Find solution alternatives ideas
Model solution alternative ideas
Evaluate and select based on pre-defined criteria
Model IT approach
Gap and re-use
Emerging
techno.
Pain points
What do
ECDC and
MS need?

9. 8
Criteria for choosing between solutions
(draft)
Criteria Meaning
Consistent Single sign on, same look and feel, consistent terminology (diseases, country codes etc.), similar design themes
(ECDC style) through all the access/dissemination channels (mobile, desktop, tablet)
Reliable Information can be trusted due to good data quality assurance processes and resulting products. IT systems
supporting surveillance should be error-free
Fit-for-purpose We must choose solutions fit for surveillance purposes.
Transparent Our surveillance processes and data manipulations are visible to appropriate users, so they know what to expect
and when
Productive Could be achieved through, for example, pre-filled templates, guided decision making, business intelligence etc.
Automated Our systems reduce manual activities/steps when appropriate
Inter-operable All surveillance tools, components and support systems are integrated (for example, through the use of
Terminology Services). Seamless information flow should not be hindered by separate technologies/platforms
Confidential The systems should facilitate access to data in a controlled manner, protecting confidential information and making
non-confidential information accessible to apprpriate audiences.
Compliant Examples of regulations that our systems should be compliant with: ECDC founding regulation, current ECDC
Director decisions, ECDC IT principles
Flexible/adaptable Our systems are flexible enough to accommodate changes in a timely manner and support innovative analysis.
Following are examples of areas where flexibility is needed: adding a new diease for reporting, producing a new
type of report if and when needed, event detection.
Competent Surveillance systems should support state of the art epidemiological methods and outputs.
Cost-Effective The design, acquisition, implementation and operation of the system should be achieved at a cost that the business
finds acceptable when judged against the benefits derived.

10. 9
When can we expect something concrete?

11. Isolate-based reporting and molecular
typing: how far should we go?
Feedback from Working Group 1
Michaela Diercke
Meeting of the National Focal Points for Surveillance
Stockholm, 12 October 2016

12. 11
Diseases
For which diseases should a more frequent reporting
be pursued for the purpose of detecting emerging
events?
• Molecular typing data would be useful for every disease, but
a matter of priority. Survey approaches may be appropriate
in many cases rather than continuous surveillance.
• Discussion both on diseases for which typing data collection
in some form and/or more frequent reporting of case-based
data would be beneficial
• Any disease which has an outbreak detection objective
(meningococci, hepatitis A etc) should be considered for
isolate-based reporting if the case-based reporting is not
frequent enough to meet the objective

13. 12
What are the main constrains for timely reporting?
• Lack of IT resources (this is also true for case-based
reporting)
• Many sources of reporting delay:
• Clinicians reporting data late to lab/public health institute
• Delay in isolate reaching laboratory
• Delay in isolates being characterised (batch testing)
• Delay in reporting of data to ECDC
• Data being kept back for publications (especially when work
co-funded by research grants)
Timeliness (I)

14. 13
How can ECDC facilitate faster reporting?
• More machine-to-machine reporting
• Information about confidentiality of TESSy to reassure users
that sharing data there does not infringe on publication
elsewhere
What is “acceptable” reporting delay?
• Disease-specific, and depends on objective for surveillance
Timeliness (II)

15. 14
• Comprehensive reporting through isolate-based reporting is not possible
for many countries:
• Some countries lack capacity to type isolates according to the methods
supported in the TESSy data collection
• Some countries have many laboratories performing characterisation,
and only a subset reaches the national public health laboratory
• Emergence of private laboratories and culture-independent testing has
reduced the number of isolates available to many national public
health laboratories
• Linking of lab and epi data:
• Not systematically done in many MS; for low incidence diseases it can
be done manually based on dates, age and gender
• Proposal to ensure that for all isolate-based reporting, it should be
technically possible to link multiple isolates to the same case
Completeness

16. 15
• Unless epi and lab data can be systematically linked in a
majority of MS, removal of overlapping case and isolate
variables is not possible
• Machine-to-machine would be the main way to reduce
burden of reporting, especially for more frequent
submissions
• A presentation (by Austria?) on practical experiences of
machine-to-machine reporting to TESSy would be useful at
the next NFP Surveillance meeting
Reporting pathways

17. 16
Thank you for your attention

18. 17
Reserve slides

19. 18
1) Make the surveillance management
transparent to data providers
SSR solutions
1. One collaborative surveillance platform
2. User-customisable activity monitoring dashboard
3. New semi-automated validation process (upload-validate-
submit)
4. New meta-dataset management system
5. Electronic workflows and document management systems
to support reviews and approvals

20. 19
2) Reduce the surveillance burden
SSR solutions
1. Data pull/push possible (HAI, isolate-based reporting)
2. Semi-automated upload-validation-submission
3. Simplified permission management (one role for
upload/submit)
4. Less mandatory fields in TESSy
5. Meta-dataset stability
6. Machine-supported assessment and decision-making

21. 20
3) Integrate surveillance systems
SSR solutions
1. One entry for EPIS/TESSy
2. Seamless data flows between surveillance applications
3. Surveillance data can be explored/analysed while
investigating events and the other way around
4. Same look and feel across applications
5. Single sign in

22. 21
4) Find ways to promote visibility of national
data providers with their National authorities
(MoH)
5) Enhance feedback to data providers
SSR solutions
1. Country profiles (across diseases)
2. Country Disease Data Feedback report
3. Access to the collaborative platform
4. Surveillance process monitoring dashboard

23. 22
6) Keep emphasis on data interpretation
SSR solutions
1. Repositories of data ready to be analysed
2. Cleaned communicable disease data
3. Easily accessible external data sources
4. Repository of thresholds and public health targets
5. Repository of events and threats
6. Automated routine analyses free up time for advanced
analyses
7. Connect EQA results with epidemiological analyses
8. Better surveillance systems descriptors

24. 23
7) Monitor use of data from third parties
SSR solutions
1. Electronic workflow to handle requests
2. Requests list available to data providers
3. Tools for tracking publications

25. 24
8) Strengthen visualisation tools especially
for event based surveillance
• EPIS mobile app
• Threats dashboard
• Determinants dashboard
• Tools for integrated microbiological (genetic distance and
phylogenetic tree) and epidemiological (geospatial
distribution) data visualisation

26. 25
Process example: collect communicable
disease data

27. 26
Data modelling – data objects