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![Update: FY 2010
• Improved and consolidated internal contract management for the
BioSense system, with savings being applied directly to increase funding to
support local and state health departments’ (SHD) syndromic surveillance
efforts
– BioSense provided ~11% of
allocated funding to 16 states, DC,
and 4 cities through ELC [awarded
September 2010] supporting ~37
FTEs at the S&L levels
– Funded (>$1M) CSTE, ASTHO,
NACCHO, and ISDS to assist with
BioSense redesign and MUse
initiative
– Only one contract: RTI International
FY 2010, provided ~$3M in funding to 16 states, 4 cities,
to assist with the redesign effort and Washington, DC through ELC Cooperative Agreement](https://image.slidesharecdn.com/biosenseredesignupdate-to-isds12-02-10public-110121012354-phpapp01/85/Introducing-BioSense-Program-Redesign-4-320.jpg)
![Stakeholder Input: Feedback Forum Posts
Total State-Level Local-Level
Post Name Post Post Date Data Pull Date Forum Post Direct Link
Responders Respondents Respondents
https://spreadsheets1.google.com/ccc?ke
Public Health y=tHPow-
Feedback Forum 1 09/24/2010 10/29/2010 10 3 3
Situation Awareness vIOUKUAq_VZHD3lgQ&authkey=CKix6v
8O&hl=en&authkey=CKix6v8O#gid=0
https://spreadsheets0.google.com/ccc?ke
Public Health y=t0YWgbihc0PUeQM2JgPYk7g&authke
Feedback Forum 2 10/15/2010 11/2/2010 14 6 8
Situation Awareness: y=COn3lrcK&hl=en&authkey=COn3lrcK#
gid=0
https://spreadsheets0.google.com/ccc?ke
Public Health y=tEJKGc3QzLhxe4YI3jTOE6w&authkey
Feedback Forum 3 10/29/2010) 11/12/2010 15 7 7
Situation Awareness: =CIKS2n8&hl=en&authkey=CIKS2n8#gid
=0
Source: Feedback Forum Posts 1-3, Available under “Your Requirements” at: https://sites.google.com/site/biosenseredesign
Total Number of Respondents = 39 [Answers Range: 4-15]; September 1 – November 12, 2010](https://image.slidesharecdn.com/biosenseredesignupdate-to-isds12-02-10public-110121012354-phpapp01/85/Introducing-BioSense-Program-Redesign-13-320.jpg)
Uploaded byTaha Kass-Hout, MD, MS
Introducing BioSense Program Redesign
The document outlines the redesign efforts of the Biosense program aimed at enhancing national and regional health-related event awareness and improving public health outcomes. Key strategies include increasing participation, maintaining a streamlined approach, and fostering collaboration across agencies to support local health monitoring. Feedback from stakeholders indicates the value of a holistic surveillance picture for outbreak tracking and resource allocation, while highlighting challenges related to data sharing and infrastructure.
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Introducing BioSense Program Redesign
- 1. Taha A. Kass-Hout,MD, MS Deputy Director for Information Science BioSense Program Manager Samuel L. Groseclose, DVM, MPH Director (Acting) Division of Healthcare Information (DHI) Public Health Surveillance Program Office (PHSPO) Office of Surveillance, Epidemiology, and Laboratory Services (OSELS) Centers for Disease Control & Prevention (CDC) Barbara L. Massoudi, MPH, PhD Senior Research Health Scientist BioSense Redesign, Project Director RTI International an update to ISDS 9th Annual Conference introducing BioSense Program Redesign Any views or opinions expressed here do not necessarily represent the views of the CDC, HHS, or any other entity of the United States government. Furthermore, the use of any product names, trade names, images, or commercial sources is for identification purposes only, and does not imply endorsement or government sanction by the U.S. Department of Health and Human Services. Public Health Surveillance Program Office Thursday, December 2nd, 2010 Office of Surveillance, Epidemiology, and Laboratory Services
- 2. Updated Vision: Beyondearly detection Beyond syndromic • The goal of the redesign effort is to be able to provide – Nationwide and regional Situation Awareness for all hazards health-related events (beyond bioterrorism) and to support national, state, and local responses to those events – Multiple uses to support your public health Situation Awareness; routine public health practice; and improved health outcomes and public health • Our strategy is to increase BioSense Program participation and utility and to support local and state jurisdictions’ health monitoring infrastructure and workforce capacity – Requires collaboration with other CDC Programs and federal agencies Let’s not throw the baby out with the bath water… – 7 years of experience dealing with timely healthcare data (Outpatient, ED, Inpatient, Census, Laboratory, Radiology, Pharmacy, etc.) – Infrastructure reconfigured for high performance, scalability and Meaningful Use (MUse)
- 3. A 3-Pronged Approach Building the Connecting Sharing Base the Dots Information Working with you every step of the way
- 4. Update: FY 2010 • Improved and consolidated internal contract management for the BioSense system, with savings being applied directly to increase funding to support local and state health departments’ (SHD) syndromic surveillance efforts – BioSense provided ~11% of allocated funding to 16 states, DC, and 4 cities through ELC [awarded September 2010] supporting ~37 FTEs at the S&L levels – Funded (>$1M) CSTE, ASTHO, NACCHO, and ISDS to assist with BioSense redesign and MUse initiative – Only one contract: RTI International FY 2010, provided ~$3M in funding to 16 states, 4 cities, to assist with the redesign effort and Washington, DC through ELC Cooperative Agreement
- 5. Collaboration Collaboration Collaboration The challenge isto keep BioSense simple It is where organizations, people, networks and communications, and systems come together
- 6. Selected BioSense ProgramCollaborations • Gulf Oil Spill-associated surveillance – AL, FL, LA, MS, TX, NCEH, CDC EOC+ • Dengue case detection – Dengue Branch, FL Dept of Health, VA • State-based asthma surveillance – AL Dept of Health, VA, DoD • Non-acute dental conditions – Division of Oral Health, NC Dept of Health, NCDetect • Rabies post-exposure prophylaxis – Poxvirus & Rabies Branch • Influenza-like illness surveillance – Influenza Division – Contribution to Distribute • ISDS – MUse Workgroup
- 7. ISDS MUse Workgroup – Core elements defined (< 30) – Draft message format in review – Current work includes use case development and workflow mapping – Public comment period: December 1-17, 2010 http://syndromic.org/projects/meaningful-use
- 8.
- 9. Technical Expert Panel(TEP)—Current Status • David Buckeridge • Judy Murphy – McGill University – Aurora Health System • Julia Gunn • Marc Paladini – National Association of County – NYC Department of Health and and City Health Officials Mental Hygiene (NACCHO) • Tom Safranek, Lisa Ferland, Richard • Jim Kirkwood Hopkins – Association of State and Territorial – Council of State and Territorial Health Officers (ASTHO) Epidemiologists (CSTE) • Denise Love • Walter G. Suarez – National Association of Health – Kaiser Permanente Data Organizations (NAHDO)
- 10. Stakeholder Involvement • Seekingindividuals from professional organizations to participate in redesign effort Syndromic Coverage Map • Coordinating presence at national conferences • Identifying individuals to Requirements Gathering update the map on the collaboration site • Disseminating redesign Community Forum project information through communication channels https://sites.google.com/site/biosenseredesign
- 11. Environmental Scan The purposeof the environmental scan is to assess current best practices in surveillance and extract from them requirements to aid in the BioSense Redesign Note: The map has been initially populated with public health jurisdictions' self-reported data obtained through the Distribute project.
- 12. Stakeholder Involvement September 1stthru November 29th 2010
- 13. Stakeholder Input: FeedbackForum Posts Total State-Level Local-Level Post Name Post Post Date Data Pull Date Forum Post Direct Link Responders Respondents Respondents https://spreadsheets1.google.com/ccc?ke Public Health y=tHPow- Feedback Forum 1 09/24/2010 10/29/2010 10 3 3 Situation Awareness vIOUKUAq_VZHD3lgQ&authkey=CKix6v 8O&hl=en&authkey=CKix6v8O#gid=0 https://spreadsheets0.google.com/ccc?ke Public Health y=t0YWgbihc0PUeQM2JgPYk7g&authke Feedback Forum 2 10/15/2010 11/2/2010 14 6 8 Situation Awareness: y=COn3lrcK&hl=en&authkey=COn3lrcK# gid=0 https://spreadsheets0.google.com/ccc?ke Public Health y=tEJKGc3QzLhxe4YI3jTOE6w&authkey Feedback Forum 3 10/29/2010) 11/12/2010 15 7 7 Situation Awareness: =CIKS2n8&hl=en&authkey=CIKS2n8#gid =0 Source: Feedback Forum Posts 1-3, Available under “Your Requirements” at: https://sites.google.com/site/biosenseredesign Total Number of Respondents = 39 [Answers Range: 4-15]; September 1 – November 12, 2010
- 14. Stakeholder Input: Summary September1st thru November 12th 2010 Hospital • The BioSense Redesign Collaboration Site has been visited by a 3% broad range of public health stakeholders from all jurisdiction levels – Most (87%) felt there is value in viewing a regional or national surveillance picture State 43% • The value provided by BioSense is focused on identifying and Local tracking outbreaks and understanding disease transmission 51% patterns • While preferences for presenting information changes little during National 3% N=39 Responders a public health event, the types of data required do change • There are many barriers to data sharing, including the lack of established policies and agreements • Many syndromes or conditions (including bioterrorism-related) need to be captured to support PH situation awareness • Lack of funding and workforce deficiencies are the most common infrastructure needs • Data sharing across jurisdictions is the most common data analysis requested • Lack of tools, skills, and time account for all barriers related to data analysis Source: Feedback Forum Posts 1-3, Available under “Your Requirements” at: https://sites.google.com/site/biosenseredesign Total Number of Respondents = 39; September 1 – November 12, 2010
- 15. Public Health SituationAwareness Need for regional or national picture Value in regional or national picture Determine best allocation of countermeasure s and resources 7% Determine at No risk populations 7% 13% Determine magnitude of Track trends and disease detect outbreaks 7% to prepare jurisdiction 29% Learn from other jurisdictions 7% Follow, Distinguish understand and jurisdiction predict disease specific or transmission Yes regional trends patterns 87% 7% 29% Compare trends across jurisdictions 7% Feedback Forum Post 3, Question 6, Number of Respondents = 15 Feedback Forum Post 3, Question 6b, Number of Respondents = 15 Available under “Your Requirements” at: https://sites.google.com/site/biosenseredesign; Responses provided between September 1 – November 12, 2010
- 16. Public Health SituationAwareness Information presentation during routine surveillance Information presentation during an event Detail-level Tabulated Dynamic 16% 18% Maps Aggregate 25% 23% Dynamic Maps 17% Detail-level 19% Graphs and Graphs and Charts Charts 21% 25% Tabulated 17% Aggregate 19% Feedback Forum Post 3, Question 3, Number of Respondents = 15 Feedback Forum Post 3, Question 4, Number of Respondents = 15 Available under “Your Requirements” at: https://sites.google.com/site/biosenseredesign; Responses provided between September 1 – November 12, 2010
- 17. Public Health SituationAwareness Data needed for PH SA during routine surveillance Data needed for PH SA during an event Weather EMS Psychological 6% EMS 13% 7% 15% Syndromic 6% Absenteeism 7% Absenteeism Inpatient Prescription 6% 10% sales Inpatient Prescription 8% 11% sales 6% Lab Results Law Lab Requests 8% enforcement 10% 6% Injury 11% OTC treatment Injury sales Lab Results 11% 7% 10% OTC treatmentsales Lab Requests 10% Poison control Poison control 11% 10% 11% Feedback Forum Post 1, Question 3, Number of Respondents = 10 Feedback Forum Post 1, Question 4, Number of Respondents = 10 Available under “Your Requirements” at: https://sites.google.com/site/biosenseredesign; Responses provided between September 1 – November 12, 2010
- 18. Public Health SituationAwareness Policies that facilitate data sharing Policies that hinder data sharing Lack of interest Non-existent in surveillance data-sharing Confidentiality after event policies, MOUs, Concerns 6% contracts, 6% agreements 13% Good relationships and trust 7% Investment in personnel Politics 7% 6% Data-sharing Lack of financial Automation MOUs, resources 13% contracts, Lack of 13% agreements automation between Lack of 6% jurisdictions workforce 53% capacity 6% Reportable disease laws 13% Data-sharing POLICIES 20% No "triggers" indicating what data needs to be Identifiable data shared 13% 6% Non-existent data-sharing policies, MOUs, contracts, Data aggregation (e.g., weekly ILI); Community-driven models; such as agreements for Lack of common Distribute, and Epi-X LOCAL data data definitions 6% 6% Feedback Forum Post 2, Question 3, Number of Respondents = 13 Feedback Forum Post 2, Question 2, Number of Respondents = 13 Available under “Your Requirements” at: https://sites.google.com/site/biosenseredesign; Responses provided between September 1 – November 12, 2010
- 19. Public Health SituationAwareness Barriers to obtain data for PH SA Data sharing consistency during routine surveillance or an event Adopting a centralized Fear of data Politics system Lack of being 7% 7% understanding of compromised Data or data 7% sharing (perceived to be of no value) 27% Time and responsibilities 7% Inconsistent Consistent 50% 50% Lack of data validation Agencies 7% reluctant to share data Date reporting 13% burdens 7% Complicated Cultural systems barriers 6% Cost of data 6% 6% Feedback Forum Post 2, Question 5, Number of Respondents = 11 Feedback Forum Post 2, Question Y, Number of Respondents = 14 Available under “Your Requirements” at: https://sites.google.com/site/biosenseredesign; Responses provided between September 1 – November 12, 2010
- 20. Public Health SituationAwareness Priority syndromes or conditions to track for situation awareness Information technology (IT) and infrastructure needs Infectious disease 11 BioSense Morbidity syndromes reporting to HDs User-defined 4% 6% 4% GI EIS syndromes Fever 17% ELR to HDs 4% 4% 6% Funding capacity (to maintain Governance infrastructure) 6% Rash 22% 4% Automation 6% Respiratory Bioterrorism 4% Agents Analysis tools 13% Workforce Acute lllness 5% IT/Informatics 4% skillsets 11% Seasonal 4% ILI 8% Standard Workforce public specifications: health skillsets Access to data Reportable data (epi, data Trauma 11% 4% Injury transmission, analysis) 4% No infrastructure 11% 8% reporting Neurological needs 5% 8% 11% communicable disease 4% Feedback Forum Post 1, Question 5, Number of Respondents = 10 Feedback Forum Post 3, Question 2, Number of Respondents = 15 Available under “Your Requirements” at: https://sites.google.com/site/biosenseredesign; Responses provided between September 1 – November 12, 2010
- 21. Public Health SituationAwareness Analysis needs Analysis barriers interoperable system 8% Inadequate View zip-code analysis tools level data 22% 8% Data views Evaluating across existing systems jurisdictions Lack of 8% 38% personnel or time 45% increase local Inadequate skills level input 33% 8% consistent cross Financial functional Support data support system sharing 7% infrastructure 15% (tools for collection, analysis, and reporting) 8% Feedback Forum Post 3, Question 5b, Number of Respondents = 8 Feedback Forum Post 3, Question 5c, Number of Respondents = 4 Available under “Your Requirements” at: https://sites.google.com/site/biosenseredesign; Responses provided between September 1 – November 12, 2010
- 22. Acknowledgements • CDC • TEP Members – James Buehler*, Laura Conn, Seth Foldy – David Buckeridge*, Julia Gunn, Jim Kirkwood, Denise Love, • RTI International Judy Murphy, Marc Paladini, – Lucia Rojas-Smith*, S. Cornelia Tom Safranek, Lisa Ferland, Kaydos-Daniels*, Annette Richard Hopkins, Walter Casoglos, Rita Sembajwe, Dean Suarez Jackman, Ross Loomis, Alan O'Connor, Taya McMillan, Amanda Flynn, Tonya Farris, • ISDS Alison Banger, Robert Furberg – Charlie Ishikawa, Anne Gifford, Rachel Viola, Emily Cain • Epidemico – John Brownstein*, Clark Freifeld, Deanna Aho, Nabarun Dasgupta, Susan Aman, Katelynn O'Brien * Co-authors
- 23. Please Join Us@ biosense.redesign2010 AT gmail DOT com https://sites.google.com/site/biosenseredesign Any views or opinions expressed here do not necessarily represent the views of the CDC, HHS, or any other entity of the United States government. Furthermore, the use of any product names, trade names, images, or commercial sources is for identification purposes only, and does not imply endorsement or government sanction by the U.S. Department of Health and Human Services.