BioSense 2.0
Public Health Surveillance through Collaboration
Barbara L. Massoudi, MPH, PhD BioSense Redesign Project Director, RTI International
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. Office of Surveillance, Epidemiology, and Laboratory Services Public Health Surveillance Program Office
History of BioSense
2002 Mandated in the Public Health Security and Bioterrorism (BT) Preparedness and Response Act of 2002 Nationwide “integrated system” for early detection and assessment of potential BT-related illness
2003 Funding provided by Congress to CDC Development of BioSense infrastructure started, initial focus on: • VA and DoD • Direct reporting to CDC of detailed clinical data by civilian hospitals (initiated in 2004)
2006 Began soliciting more limited data from health departments that had already established automated systems for ED-based syndromic surveillance • By 2007, 8 state/local HDs connected
Epidemiologic Objectives Syndromic Surveillance & BioSense
Early event detection Rapid event characterization (regardless of how detected) Ongoing & timely monitoring over course of event
Situation Awareness Value Examples
2011 Japan Earthquake/Tsunami Cluster of Visits for Heat-Related Illness in Texas
2010 Dengue surveillance - Florida Gulf Oil Spill Maryland anti-infective pharmaceutical surveillance
2009 H1N1 event and Distribute
BioSense 1.0 Environment
Jurisdiction Hospital Public-Access
Recommendations from Prior Evaluations (GAO, US Senate, ASTHO, CSTE, BioSense Evaluation Project)
Strengthen state and local public health engagement Enhance state/local HD syndromic surveillance capacity Increase participation of state/local HD syndromic surveillance systems (improve coverage) Share data with HDs from hospitals reporting directly to CDC Share governance
Leverage investments in EHRs GAO, 2008: Adopt an “open, distributed computing model” Improve utility of the data and data sources Preparedness role: Greater “all hazards” emphasis Expand uses for broader spectrum of PH concerns
BioSense 2.0: Approach
Shift from a need-to-know to a need-to-share and co-create “User-Centered” design Partners engaged in every step of the redesign Low barrier to participation for HDs and their providers • HDs fully control “their data” at the level of granularity they are authorized • Support expansions in SS prompted by Meaningful Use (MUse)
More options for data sharing • HDs are able to share data directly with other jurisdictions and CDC
Alignment with ONC and MUse Agreed upon core SS data elements (CDC/ISDS/ONC collaboration)
Enhanced partnerships States (ELC): MUse SS adoption, building capacity, joining BioSense 2.0 Collaborations with associations (ASTHO, CSTE, NACCHO) and ISDS
Simple and unobtrusive technology option Cloud technology; distributed, easy to adopt, cost-effective, and secure
The Cloud: A Scalable Solution
BioSense 2.0: Timeline
June-October 2011: Governance, Cloud, and Recruitment Established an interim S&L governance structure Identified and procured Amazon as the Cloud vendor Recruitment in coordination with ASTHO, NACCHO, CDC, and ISDS (67 jurisdictions)
November 2011: Open for Business S&L HDs can initiate or expand their syndromic surveillance systems under the MUse program for their own jurisdiction Stakeholders can begin collaborating among themselves and CDC in the new environment governed by data use agreements
By April 2012: Retire BioSense 1.0 Followed EPLC process (internal to OSELS and the CDC enterprise)
BioSense 2.0: Environment BioSense 2.0 Environment
Shared Spaces Jurisdiction Hospital Public-Access
BioSense 2.0: Environment
Four primary services Catcher’s Mitt • Provides for securely receiving (multiple channels), storing, and processing high volumes of data for jurisdictions at no cost to them
Data Conversion • Can receive all data forms and formats, including HL7 or CDA, and convert them to any format an individual health department uses
Analytics • Compatible environment for the users’ requested analytic tools, such as: SAS and R statistical packages, ESSENCE, etc
Collaboration • Allows for ad hoc or continual data sharing among jurisdictions based on data use agreements initiated by the jurisdiction and signed with ASTHO
Application Home Page
Shared Space A “View” consists of a map, timeline and metadata • Save View for viewing later or sharing • Data can be filtered by demo, sources • Statistical anomaly detection tools • A view can be annotated with notes that are saved for future use and for sharing • The View can be shared within a jurisdiction or other BioSense users (who have similar permissions) • Export View as: .csv, .html, .png, .ppt, .pdf • Self-defined alerts, based on frequency, statistics, etc. sent to email or phone
data.biosen.se
Linux virtual machine
Apache PHINMS VPN Mirth
secure FTP
NwHIN (Direct Project, Connect, etc.
credentials, metadata
BioSense 2.0: Recruitment
Recruitment is lead by CSTE and coordinated with ASTHO, NACCHO and ISDS First Tier • Jurisdictions that have explicitly communicated their interest • 26: 16 States, 3 Counties, and 7 Cities
Second Tier • Jurisdictions with either mature capacity or high value with moderate interest • 35: 29 States (including DC), 5 Counties, and 1 City
Third Tier • Jurisdictions who haven’t expressed interest at this time • 6: 6 States [LA, CA, NJ, TX, AL, and RI]
BioSense 2.0: Technical Assistance
Assist jurisdictions in joining the environment is part of the redesign contract Direct program and application TA Challenge Grants administered by the redesign contract and coordinated with the associations • FY 2012: 10 jurisdictions at $20K each
Technology and science innovation prizes administered by the redesign contract and coordinated with ISDS and academic partners
Thank You! BioSense 2.0 http://biosenseredesign.org
[email protected]
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.
