Enhanced health event detection and influenza surveillance using a joint Veterans Affairs and Department of Defense biosurveillance application

BMC Medical Informatics and Decision Making

Research Article

Frank Maldonado¹  Mark Holodniy²  Cynthia A Lucero²  Gina Oda²  Joseph Lombardo³  Richard Wojcik³  Kenneth Cox⁴ 

[1] Associate Chief of Staff for Clinical Affairs, Department of Veterans Affairs, Captain James A. Lovell Federal Health Care Center, 3001 Green Bay Rd, 60064, North Chicago, IL, USA;Department of Veterans Affairs, Office of Public Health, Office of Public Health Surveillance and Research, 3801 Miranda Ave (132), 94304, Palo Alto, CA, USA;Johns Hopkins University Applied Physics Laboratory, ESSENCE Group, 11100 Johns Hopkins Road, 20723, Laurel, MD, USA;Medical Informatics and Special Projects, Armed Forces Health Surveillance Center, 2900 Linden Lane, Suite 200, 20910, Silver Springs, MD, USA;

关键词: Veteran Affair;    Situational Awareness;    Cook County;    Influenza Surveillance;    Veteran Affair Facility;   

DOI  :  10.1186/1472-6947-11-56

 received in 2011-02-10, accepted in 2011-09-19,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThe establishment of robust biosurveillance capabilities is an important component of the U.S. strategy for identifying disease outbreaks, environmental exposures and bioterrorism events. Currently, U.S. Departments of Defense (DoD) and Veterans Affairs (VA) perform biosurveillance independently. This article describes a joint VA/DoD biosurveillance project at North Chicago-VA Medical Center (NC-VAMC). The Naval Health Clinics-Great Lakes facility physically merged with NC-VAMC beginning in 2006 with the full merger completed in October 2010 at which time all DoD care and medical personnel had relocated to the expanded and remodeled NC-VAMC campus and the combined facility was renamed the Lovell Federal Health Care Center (FHCC). The goal of this study was to evaluate disease surveillance using a biosurveillance application which combined data from both populations.MethodsA retrospective analysis of NC-VAMC/Lovell FHCC and other Chicago-area VAMC data was performed using the ESSENCE biosurveillance system, including one infectious disease outbreak (Salmonella/Taste of Chicago-July 2007) and one weather event (Heat Wave-July 2006). Influenza-like-illness (ILI) data from these same facilities was compared with CDC/Illinois Sentinel Provider and Cook County ESSENCE data for 2007-2008.ResultsFollowing consolidation of VA and DoD facilities in North Chicago, median number of visits more than doubled, median patient age dropped and proportion of females rose significantly in comparison with the pre-merger NC-VAMC facility. A high-level gastrointestinal alert was detected in July 2007, but only low-level alerts at other Chicago-area VAMCs. Heat-injury alerts were triggered for the merged facility in June 2006, but not at the other facilities. There was also limited evidence in these events that surveillance of the combined population provided utility above and beyond the VA-only and DoD-only components. Recorded ILI activity for NC-VAMC/Lovell FHCC was more pronounced in the DoD component, likely due to pediatric data in this population. NC-VAMC/Lovell FHCC had two weeks of ILI activity exceeding both the Illinois State and East North Central Regional baselines, whereas Hines VAMC had one and Jesse Brown VAMC had zero.ConclusionsBiosurveillance in a joint VA/DoD facility showed potential utility as a tool to improve surveillance and situational awareness in an area with Veteran, active duty and beneficiary populations. Based in part on the results of this pilot demonstration, both agencies have agreed to support the creation of a combined VA/DoD ESSENCE biosurveillance system which is now under development.

【 授权许可】

CC BY   
© Lucero et al; licensee BioMed Central Ltd. 2011