A concept for routine emergency-care data-based syndromic surveillance in Europe

Abstract

We developed a syndromic surveillance (SyS) concept using emergency dispatch, ambulance and emergency-department data from different European countries. Based on an inventory of sub-national emergency data availability in 12 countries, we propose framework definitions for specific syndromes and a SyS system design. We tested the concept by retrospectively applying cumulative sum and spatio-temporal cluster analyses for the detection of local gastrointestinal outbreaks in four countries and comparing the results with notifiable disease reporting. Routine emergency data was available daily and electronically in 11 regions, following a common structure. We identified two gastrointestinal outbreaks in two countries; one was confirmed as a norovirus outbreak. We detected 1/147 notified outbreaks. Emergency-care data-based SyS can supplement local surveillance with near real-time information on gastrointestinal patients, especially in special circumstances, e.g. foreign tourists. It most likely cannot detect the majority of local gastrointestinal outbreaks with few, mild or dispersed cases.

Ambulance dispatch calls attributable to influenza A and other common respiratory viruses in the Netherlands (2014‐2016)

“…3 Syndromic surveillance using ready-to-use data has also been explored, mainly in emergency rooms. [5][6][7] Few initiatives have used ambulance data 5,8,9,10 or ambulance dispatch centre data. 5,8,10,11 Ambulance dispatch centres could be an alternative source of readily available data to monitor the occurrence of severe respiratory infections.…”

What is the utility of using syndromic surveillance systems during large subnational infectious gastrointestinal disease outbreaks? An observational study using case studies from the past 5 years in England

“…The utility of syndromic surveillance in identifying or monitoring subnational infectious GI outbreaks is less clear. This has been explored in the literature previously [9][10][11][12] using either modelled or retrospectively identified case studies, with varying results. In England, a study using a synthesized cryptosporidiosis outbreak, found that the surveillance system would be unlikely to detect such an outbreak [12].…”

National and Regional Representativeness of Hospital Emergency Department Visit Data in the National Syndromic Surveillance Program, United States, 2014

“…[1][2][3][4][5][6][7][8][9] Syndromic surveillance is a process by which public health agencies, hospitals, medical professionals, and other organizations share, analyze, and query health and health-related data in near real time to make information on the health of communities available to public health and other officials for situational awareness, decision-making, and enhanced responses to hazardous events and disease outbreaks. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Syndromic surveillance is distinguished from other public health surveillance systems by the combination of several characteristics, including automated exchange of data originally created for other purposes from clinical electronic health information systems and other sources, the creation of defined syndromes based on words in clinic text notes and diagnostic and treatment information when available, and automated data scans to detect and display statistical anomalies and alert users to potential adverse health events. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Although users and...…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Syndromic surveillance is distinguished from other public health surveillance systems by the combination of several characteristics, including automated exchange of data originally created for other purposes from clinical electronic health information systems and other sources, the creation of defined syndromes based on words in clinic text notes and diagnostic and treatment information when available, and automated data scans to detect and display statistical anomalies and alert users to potential adverse health events. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Although users and researchers are still assessing the uses and limitations of the systems, 10,11 many health agencies find syndromic surveillance to be an important addition to their other surveillance systems. [1][2][3][4][5][6][7][8][9][10]…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Syndromic surveillance systems provide agencies with near real-time data on a broad range of health conditions for large populations, allowing them to adapt quickly to new public health surveillance needs. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] The Health Information Technology for Economic and Clinical Health Act (HITECH Act), enacted under Title XIII of the American Recovery and Reinvestment Act of 2009 (Pub L. 111-5), authorized the US Department of Health and Human Services (HHS) to promote the adaptation and meaningful use of health information technology such as electronic health records to improve population health and strengthen public health surveillance for outbreak management or mitigation of public health disasters. 17 In September 2012, HHS identified syndromic surveillance as an objective for hospitals and health professionals to receive incentives from the Centers for Medicare and Medicaid Services for submission of syndromic surveillance data to public health agencies.…”