Empowering a Community for Outbreak Investigation

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Cathleen Powell
6 years ago
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1 Empowering a Community for Outbreak Investigation Image courtesy of Centers for Disease Control and Prevention OutbreakNet 2012 August 29, 2012 Image courtesy of the Office of United States Trade Representative Nicholas Hill, MPH Disease Surveillance Manager Epidemiologist, SD-DOH 1

2 Historical data flow; nodes still LAB RESULTS, Faxed or mailed Lab Report stubbornly persist CENTRAL OFFICE CDC NETSS report Manual Enter to STD*MIS, etc. Manual Enter to Spreadsheet Manual Data Analysis Manual Entry to Word, Save, Print, & to DIS Office DIS OFFICE DIS Saves and Prints CO checks and sends back if further investigation warranted Alerts Record Retention DIS hand write notes DIS re-keys notes into Word, Save, Reprint, File and it back to CO CENTRAL OFFICE

3 Status of Public Health Lack of funding Lack of staffing resources Jurisdictional turf wars Lack of system capabilities Lack of technical expertise Not engaging the right partners Growth of government under intense scrutiny Benefits of new methods not clearly understood 3

4 Meaningful Use Has potential to have dramatic impact, put our targets in focus, bridge the gap between clinical medicine and public health. Advantages: systematic and standardized way to collect and share patient information, formatted digitally, facilitated data exchange, tracking care, reminder/warnings, validating outcomes, statistical evaluations, security, audit tracking. 4

5 We re still missing the most important part of the picture 5

6 PATIENTS conducting their own investigations as soon as diagnosed or lab results are reported. Image courtesy of Centers for Disease Control and Prevention 6

7 Empowering the Patient Equip them and give them their advocacy role. Public health can see the patient more quickly Investigations more effective while patient still infectious Intervention efforts are closer to the fire Prompt and quality feedback to clinical medicine Tracking population trends and statistics Clearly identify problems and gaps in need Evaluate and increase effectiveness of population-based prevention & control 7

8 Empowering Communities 8

9 SDEDSS Dynamic Outbreak and Survey Builder 9

10 SDEDSS Dynamic Questionnaire Builder 10

11 SDEDSS Dynamic Questionnaire 11

12 SDEDSS Report Builder 12

13 9pm 10pm 11pm midnight 1am 2am 3am 4am 5am 6am 7am 8am 9am 10am 11am later SDEDSS Outbreak Reports Walking tacos served 31 Jan 1 February Table 1. Symptoms of Ill cases, Pierre/Mitchell Boys High School Basketball Outbreak, Jan, Symptom Responses Number with Symptom % with symptom Diarrhea % Watery diarrhea % Bloody diarrhea % Abdominal cramps % Nausea % Vomiting % Fever % Headache % Chills % Weakness % Constipation % Table 2. Analytical epidemiology: statistical breakdown of foods served at the Pierre/Mitchell Boys High School Basketball Outbreak, Jan, Ill Persons Well Persons Food Did consume Did not consume Did consume Did not consume RR 95% CI P Walking Taco << Taco Meat << Taco Cheese << Taco Lettuce << Taco Sour Cream << Taco Salsa << Taco Chips << Hot Dogs Pizza Popcorn Fountain pop

14 Future SDEDSS Vision CLINICIAN REPORT ELR-EMR EXCHANGE SDEDSS Local, State, Federal, International Exchange Partners PATIENT DRIVEN DATA FLOW

15 Moving out of the trench Public Health must realize we have a smarter, more mobile, more informed PUBLIC. Need to develop tools to engage and leverage these resources to advance public health. Public must be brought into the process. 15

16 FDOMS predecessor system The PATIENT conducts their own interview as soon as symptoms develop, diagnosed, or lab result is available. Demonstration of FD-OMS (front side) Demonstration of FD-OMS (back side) 16

17 Question Package FDOMS front end

18 Question Package FDOMS See test URL for complete system form and fields (front end, only)

19 Workflow FDOMS Back end

20 Print Template FDOMS Back end

21 Data Export FDOMS Back end

22 Sample report I live and sleep with stray pups and dogs. I live with street people who are alcoholics. My trailer has no utilities no plumbing no inside bathroom and no running water. Trailer is run down and unlivable. I cook outside in the open fire. Salmonellosis case: self-reported history submitted online

23 SDEDSS Create model in SDEDSS for all disease conditions, with FDOMS data import. Build and expand for routine surveillance and outbreak detection. Standardize all models to FoodCORE model and share real time data w/cdc 23

24 Summary Patient is given the tools and control (FDOMS and SDEDSS patient portal) Patient is the primary advocate for Public Health Public Health takes the back seat. We become data and information managers, not hunter gatherers. Data shared near real-time EpiNet?? 24

Yersiniosis rev Apr 2017

Yersiniosis rev Apr 2017 rev Apr 2017 BASIC EPIDEMIOLOGY Infectious Agent Yersinia species, a Gram negative bacilli. Y. enterocolitica is the species most commonly associated with human infection. Y. pseudotuberculosis infection