Monitoring Community Health with INDICATOR

Transcription

1 Monitoring Community Health with INDICATOR Ian Brooks, Ph.D. HITC Workshop November National Center for Supercomputing Applications University of Illinois at Urbana-Champaign

2 Health Sciences Major Themes Global Health INDICATOR Health monitoring Endemic Disease decision support systems Malaria Map Patient Safety Algorithmic Medicine Next Generation Medical Records Virtual Hospital Remote Monitoring and Education

3 INDICATOR: An Infectious Disease Informatics CyberEnvironment

4 What s different about INDICATOR? Designed to be bottom up No predefined data requirements Rapid response to data providers and local public health Framework for Health Monitoring (Modeling & Response) Handling different types of data Enable use of a variety of different algorithms Collaboration tools Epidemiological Investigation and prediction tools Working with other systems, not competing with them

5 INDICATOR: Philosophy Combine multiple sources of imperfect data to create picture It is better to have imperfect data than no data Take the data that is available Minimize regulatory burdens Separate data analysis from case follow-up Focus on the population level Start small and local

6 Main Technical Goals Combine Surveillance Data Sources Clinical diagnoses Syndromic information Attendance records Animal surveillance Environmental data Enable results of surveillance to be used as input for models Enable easy submission of multiple modeling studies to supercomputing resources Provide collaborative tools to discuss results with response planners

7 Current Data Status Data Type Frequency Contents Start Date Carle Emergency Department Daily ICD-9 January 2006 Carle Emergency Department Daily Chief Complaint, Discharge Dx April 2009 Christie Convenient Care Clinic Daily ICD-9 Dx January 2006 Provena Emergency Department Daily ICD-9 Dx, Chief Complaint September 2012 Patient Advisory Nurse Daily Chief Complaint April 2007 IDPH Reportable Diseases Monthly Reported Disease Count January 2007 School Attendance Weekday Absenteeism w or w/o illness August 2008 Animal Control Monthly Animal Bites by Species January 2006 Weather Daily Temperature, Rainfall, etc. January 2006 Pollen / Airborne Allergens Daily Pollen Count / Particulates July 2012

8 New Data Feeds Data Type Frequency Contents Start Date Carle Convenient Care Clinic Daily ICD-9 Dx? Vet Med Data Base Weekly Dx September ASPCA Poison Control Weekly Outdoor toxins September Private Vet Clinics Weekly Dx (6 Zoonotic Diseases)?

9 Experiences getting data Different partners have different requirements Biggest roadblock is confused lawyers It helps to have a partner champion Healthcare providers want a specified data format

10 One Health unified data format (draft) 1. Presentation Date 2. Dx Code (SNOMED, ICD-9, ICD-10,LOINC etc.) 3. Dx Free Text 4. Chief Complaint Free Text 5. Location of Reporting Facility 6. Count 7. Species 8. Notes Irrelevant or unavailable fields can be left blank

11 PAN vs ED for ILI 1 Pandemic PAN/ED ILI Convenient Care Presentations by Day of Week r PAN/ED Seasonal 2009 Pandemic Non Outbreak Lag 0 Sun Mon Tue Wed Thur Fri Sat ILI ED Presentations by Day of Week 2009 Pandemic Non Outbreak ILI PAN Calls by Day of Week 2008 Seasonal 2009 Pandemic Non Outbreak 0 Sun Mon Tue Wed Thur Fri Sat 0 Sun Mon Tue Wed Thur Fri Sat

12 H1N1 Outbreak 2009

13 Insect Bites

14 Lyme Disease as a function of Climate

15 Next Steps Continue to add data sources Expand to more communities Continue to enhance collaboration and investigation tools Apply data mining techniques and Baysian networks to develop data fusion models Integrate with GISolve Expand to support control of endemic diseases

16 Lessons learned People will willingly share data if: It doesn t cost them anything It is not sensitive They can see some benefit It is with a trusted neutral partner Look to the end users to assess value Don t underestimate policy impact Partners can start to take ownership Be flexible with development

17 Partners Champaign-Urbana Public Health District Center for One Health Illinois Carle Foundation Provena Hospital Christie Clinic Champaign County Schools Champaign County Humane Society Veterinary Medicine Data Base Illinois Water Survey Champaign County Animal Control Illinois Department of Public Health ASPCA Poison Center Imaginations unbound

18 Acknowledgements Development Team Bernie A cs Wendy Edwards Mario Felarca Surabhi Rao Tom Redman Matt Vaughan Andrew Wadsworth Funders Carle Foundation USDA CDC Center for One Health Illinois IDPH

19 Questions?