Bio. Sense: Using Health Data for Early Event Detection and Situational Awareness DIMACS Working Group on Bio. Surveillance Data Monitoring and Information Exchange February 23, 2006 Blake Caldwell, MD, MPH Senior Advisor Coordinating Center for Health Information and Service Centers for Disease Control and Prevention TM
Bio. Sense Real-time (RT) Vision • Provide capabilities for early event detection and situational awareness for public health Approach • Enable real-time delivery of emergency room, ambulatory, and acute care data from hospitals to Bio. Sense • Provide electronic “views, ” analytics, and reports for national, state, and local public health, hospital, and government officials TM
Health Situational Awareness Confirm or refute existence of an event ü ü ü Environmental signal Suspect illness Intelligence warning Monitor ongoing event and effectiveness of response ü ü ü Ascertain size of event Ascertain rate of spread Track efficacy of response efforts Monitor for adverse events Know when an event has passed TM
Bio. Sense RT Implementation Concepts • Real-time transmission of existing clinical diagnostic and health information • Industry-accepted standards used where they exist; developed where standards do not yet exist • Data transformation to standards occurs at hospital level, contributing to local electronic health record activities TM
Bio. Sense RT Implementation Concepts (continued) • Simultaneous access of data for analysis and visualization by all jurisdictional levels of public health (hospital, city, county, state, national) • System is robust, flexible, and intended for dual and future use • Harmonized with PHIN, the NHIN Public Health architecture TM
Bio. Sense Clinical Data A rich clinical data source to include Patient-level data • Demographics (obvious identifiers removed) • Preliminary/Working/Discharge Diagnoses • Discharge disposition • Chief complaint, symptoms, vital signs • Procedures and orders (Lab, Radiology, Pharmacy) • Laboratory results Hospital-level data • Resources and bed utilization TM
Bio. Sense Hospital Recruitment Hospitals prioritized by focusing on • Large metropolitan areas • Top 5 emergency departments by volume in area • Existing IT infrastructure, especially ED system • Health systems with multiple hospitals • Recommended by local public health Hospitals and public health generally enthusiastic Bio. Sense RT recently supported by the Council on State and Territorial Health Epidemiologists (CSTE) TM
Cities with Bio. Sense Hospitals 2005 Commitments • • • Atlanta, GA Baltimore, MD Boston, MA Chicago, IL Columbus, OH Dallas, TX Denver, CO El Paso, TX Indianapolis, IN • • • Las Vegas, NV Los Angeles, CA Miami, FL Milwaukee, WI Philadelphia, PA Phoenix, AZ Portland, OR San Diego, CA St. Louis, MO Washington D. C. TM
Hospital Commitments to Bio. Sense, 2005 Beth Israel Deaconess and Boston Children’s Oregon Health & Sciences University Aurora (13) Jefferson Health (13) Stroger (3) Denver Health University Medical Center LA County and Children’s LA Regenstrief (17) Mount Carmel (3) Johns Hopkins (3) BJC Healthcare (13) Banner Health (5) Washington Hospital Center (7) Tenet (2) Sharp (4) and UC San Diego (2) Gwinnett Health System (2) Cook Children’s and Baylor (14) Miami Children’s 19 Cities 110 Hospitals TM
Bio. Sense Implementation in 2005 Beth Israel Deaconess Aurora (13) Jefferson Health Stroger University Medical Center Mount Carmel (3) Washington Hospital Center (6) Sharp (4) Gwinnett Health System (2) 10 Cities 32 Hospitals TM
Bio. Sense Implementation Timeline Dec’ 05 Apr’ 06 Aug’ 06 Dec’ 06 10 cities – 65 initial hospitals Pharmacy, Clinical and Lab Rad Foundation 9 cities – 45 hospitals Pharmacy, Clinical and Lab Rad Foundation 12 add’l Bio. Watch cities – ? hos Pharmacy, Clinical and Lab Rad Foundation TM
Priorities for 2006 • Continue enrollment • Become operational • Negotiate MOUs with CSTE/states • Implement Pan Flu expansions • Convene Vanguard Groups – April (hospital participants, state and local health departments, scientists) TM
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