ESSENCE

Drug poisoning, or overdose, is an epidemic problem in the United States1,2. In keeping with national trends, a recent study combining U.S. Veterans Health Administration (VHA) data with the National Death Index showed increases in opioid overdose mortality from 2001 to 20093. One of the challenges in monitoring the overdose epidemic is that collecting cohort data to analyze overdose rates can be laborintensive. Moreover, analysts are often unable to collect real-time data on overdose events. To explore solutions to these challenges, we examined opioid overdose by using Veteran healthcare data already being collected for syndromic surveillance.

Objective

To examine inpatient admissions for opioid overdose among U.S. Veterans using national-level surveillance data.

 

The compliance date for the ICD9-ICD10 transition is October 1, 2015. The hospitals have started the ICD9-ICD10 transition. However, not all data providers will transition the data at the same time. In order to facilitate some coherence to the data during this transition period, user interface and data processing functionalities have been developed in ESSENCE to allow usage of both classification systems simultaneously. This capability will allow users to perform ICD10- based queries across all the hospitals in their system, irrespective of the exact number of hospitals that have completed the ICD10 transition.

Objective

To help users seamlessly query and analyze data in disease surveillance systems using both ICD9 and ICD10 codes during the transition period. Additionally, the mappings between ICD9 and ICD10 codes must be flexible enough to support locally required changes based upon a user’s needs.

The National Strategy for Biosurveillance promotes a national effort to improve early detection and enable ongoing situational awareness of all-hazards threats. Implicit in the Strategy’s implementation plan is the need to upgrade capabilities and integrate multiple disparate data sources, including more complete electronic health record (EHR) data into future biosurveillance capabilities. Thus, new biosurveillance applications are clearly needed. Praedico™ is a next generation biosurveillance application that incorporates cloud computing technology, a Big Data platform utilizing MongoDB as a data management system, machine-learning algorithms, geospatial and advanced graphical tools, multiple EHR domains, and customizable social media streaming from public health-related sources, all within a user friendly interface.

Objective

The purpose of our study was to conduct an initial assessment of the biosurveillance capabilities of a new software application called Praedico™ and compare results obtained from previous queries with the Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE).

 

ILINet is used nationwide by sentinel healthcare providers for reporting weekly outpatient visit numbers for influenza-like illness to CDC. The Florida Department of Health receives urgent care center (UCC) data through ESSENCE from participating facilities. Seminole County is unique in that its four sentinel providers located in separate UCCs report into both systems, and all their discharge diagnoses are available through ESSENCE. However, the reported number of patients being discharged from those providers with diagnoses of influenza is not equivalent to the number of cases reported into ILINet. Data from the two systems were therefore compared both among and between the individual sentinel providers in order to determine the extent of the variation over four influenza seasons.

Objective

To compare influenza-like illness (ILI) data reported to the Centers for Disease Control and Prevention (CDC) U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) with discharge diagnosis data for influenza from the same reporting source obtained through the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) in Seminole County, Florida.

Syndromic surveillance has historically been used to track infectious disease, but in recent years, many jurisdictions have utilized the systems to conduct all hazards surveillance and provide situational awareness with respect to previously identified issues. Flakka is a synthetic drug (class: cathinones) that recently has been featured in the media. Flakka is a stimulant that causes delusions, aggression, erratic behavior, a racing heart and sometimes death. Two specific counties (one in Florida and one in Kentucky) have been at the center of this emerging epidemic. In August 2015, Florida Department of Health (FDOH) partner agencies requested flakka-related health data in an effort to better understand the epidemiology and context of this problem. ESSENCE-FL is a large syndromic surveillance system, with four main data sources, that captures 87% of all emergency department (ED) visits statewide.

Objective

To characterize flakka usage in Florida using multiple data sources within the Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE-FL)

There are currently over 25 installations of ESSENCE across the US. Among these, there are 3 instances of multi-jurisdictional implementations. These include a centralized regional system in the National Capital Region for MD, DC, and VA, a Missouri system that includes hospitals and users from the St. Louis area in Illinois, and soon the National Syndrome Surveillance Program (NSSP) version of ESSENCE which will centralize data from many jurisdictions. While each of these systems provides valid ways to share data across jurisdictions, they require data to be sent to another jurisdiction. There are some jurisdictions which have legal or philosophical or technical issues with these types of data sharing arrangements. Programs like Distribute attempted to solve this by only sharing pre-aggregated data. This caused issues though for surveillance of new and emerging issues that requires a more ad-hoc query capability. This gap can be filled with a locally-ran system that has the ability to perform queries into remote systems and perform a federated query across other jurisdictions.

Objective

The objective of this presentation is to describe the new federated query capability in ESSENCE and describe how this could affect public health practice in the future. Specifically, this presentation will describe how a federated set of disease surveillance systems across the country could help improve national disease surveillance situational awareness along with its potential to connect non-ESSENCE systems in the future for even more complete coverage. It will also describe how this capability is different than other data sharing projects that attempt to centralize data, but how there is room for both to benefit from each other.