Download H1N1 Disease Surveillance Team Project Week 5 Presentation

H1N1 Disease Surveillance
Team Project
Week 9 Presentation
Melody Dungee
Beena Joy
David Medina
Calvin Palmer
H1N1 BioSurveillance
• County Public Health System (CPHS)
• Local H1N1 infection surveillance system
• Architecture based on work flows
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•
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Laboratory Alert: H1N1 Test Order
Laboratory Alert: H1N1 Test Result
Web-based H1N1 Biosurveillance Document (NEDSS)
Clinical Information System Alert
• Information Architecture
• Origin of individual data elements
• Data flow
Information Architecture
Clinician
•
CPHS H1N1 Surveillance
System
•
Actors
CPHS Official
Clinician
Terminal
Clinician Terminal
Web Browser
Web-based
NEDSS
NEDSS
Terminal
Application Interface
HL7/XML | C35, C36, C37, C39
HTTPS
HTTPS
CIS
EAI
• Clinician/Provider/Public
Health Officials
HL7
LIMS
EAI
HL7
• Clinical Information
System (EMR/EHR)
CIS
LIMS
Enterprise Application Integration (EAI)
• Laboratory Information
Management System
(LIMS)
HL7
• CPHS Biosurveillance
Database
HTTP/
S
C35
C36
C37
C154
CPHS
BioSurveillance
Database
Database Tools
Report
Data Mine
System
Functions
CPHS Biosurveillance System
Query
Origin of Data Elements
• Data Sets
•
•
•
•
•
•
Demographics
Clinical Data (Signs, Symptoms)
Medical History (Immunization, Disease)
Diagnostic Findings (Lab Test, Lab Results)
Treatment
Epidemiology
Origin of Data Elements
Data Set
Data Element
Demographics Date of Birth
Race
Ethnicity
Sex
Clinical Data
Date symptom
onset
Signs and
Symptoms
(SNOMED
Concept Codes)
Was the patient
hospitalized?
Patient admitted
to the intensive
care unit?
Source
System
Primary: CIS
(Hospital,
Provider)
Secondary:
LIMS
(Laboratory)
CIS (Hospital,
Provider)
Collection Scenario
I. Obtained by provider during patient encounter and
registration, stored in CIS by clinician
II. Obtained at hospital registration, stored in CIS
III. May be accessed by laboratory LIMS through CIS
interface
I.
Entered into CIS by clinician/provider as a result of the
patient encounter, or hospitalization.
Origin of Data Elements
Data Set
Medical
History
Data Element
Received Flu vaccine between 9/2008
and 3/2009?
•Number of doses?
•Vaccine type?
Existing Conditions?:
•Asthma
•Other Chronic Lung disease
•Chronic heart or circulatory disease
•Metabolic disease (including diabetes
mellitus)
•Kidney disease
•Cancer in the last 12 months
•Immunosuppressive condition (HIV
infection, chronic cortico-steroid
therapy, organ transplant recipient
•Other chronic diseases
•Neurological disease
Source
System
CIS
(Hospital,
Provider)
Collection Scenario
I.
Obtained by clinician/provider from the
medical history interview during the
patient encounter, stored in CIS
II.
Obtained at hospital registration, stored
in CIS by hospital admin staff, data
automatically ported to CIS
Origin of Data Elements
Data Set
Diagnostic
Findings
Data Element
Leukopenia (Y/N)
Source
System
Collection Scenario
CIS (Hospital, I.
Provider)
Provided by provider or hospital-based
clinician during patient encounter as a result
of the diagnostic testing and treatment
decisions made by the clinician, stored in
CIS by clinician or staff
Primary:
LIMS
(Laboratory)
Test orders are entered and stored in the
LIMS system when ordered by clinician. Test
orders are also stored in CIS if ordered
through
Lyphopenia (Y/N)
Thrombocytopenia (Y/N)
Tests Taken?
Chest X-Ray (norm, abnorm)
Chest CT scan (norm, abnorm)
Influenza testing?
Date collected/ specimen ID
Specimen type
Test type
Results
Type/Subtype (specimens sent
to CDC, when, what type, ID)
Date
Specimen
State Lab ID
I.
Secondary:
CIS (Hospital, II.
Provider)
III.
Test results are entered and stored into
LIMS system
Test results are transmitted to clinician
when finalized and stored in the CIS
Origin of Data Elements
Data Set
Data Element
Source
System
Collection Scenario
Treatment
Antiviral Medication?
Drug – from list provided
Date initiated
Date discontinued
Dosage
CIS (Hospital, I.
Provider)
Provided by provider or hospital-based
clinician during patient encounter as a result
of the diagnostic testing and treatment
decisions made by the clinician, stored in
CIS by clinician or staff
Epidemiology
Questions re: 7 days prior to
onset (Y, N, U):
Mexico travel?
Close contact?
Handle samples?
Family/close contacts w/ flulike illness?
Household transmission
Number of inhabitants?
Inhabitants w/ flu symptoms?
Inhabitants tested for flu
(number tested, date tested,
test result)?
CIS (Hospital, I.
Provider)
Obtained by clinician/provider from medical
history interview during the patient
encounter, stored in CIS
Flow of Data Sets
Questions?