Q Dedicated to enhancing the health and safety of Canadians through public health informatics

Queen’s University Public Health Informatics (QPHI) Team

www.quesst.ca

Occupational Health Surveillance

Tara DonovanQPHI Surveillance MeetingExploring Surveillance OpportunitiesJune 13th, 2008

Innovative, Integrated, Syndromic Surveillance System Purpose: Develop an automated, integrated,

syndromic surveillance system

Method: Use routinely collected electronic Occupational Health (OH) visit data in addition to Emergency Department (ED) visit data

Q Dedicated to enhancing the health and safety of Canadians through public health informatics

Objectives Objective 1: Monitor respiratory and gastrointestinal

illness activity both within the community (ED) and hospital (OH) To detect outbreaks earlier To facilitate investigations and necessary

interventions

Objective 2: Evaluate the ability of the system to detect a sentinel event such as a nosocomial infection or the effect of a community outbreak on staffing levels at the hospital

Ethics Queen’s University Health Sciences and

Affiliated Teaching Hospitals Research Ethics Board

Privacy Impact Assessment Compliant with PHIPA

OH Reporting Legislation/ Recommendations SARS Commission Final Report (Campbell)

Ontario Health Plan for an Influenza Pandemic

Recommendations for Infection Control/ Surveillance MOHLTC (Task Force)

Enteric Disease Surveillance Protocol for Ontario Hospitals (OHA & OMA – CD protocols)

Collected Occupational Health Visit Data Daily Occupational Health visits at KGH – large tertiary care

teaching hospital Parklane® software Secure VPN data transfer (Citrix Access Gateway)

Date and Time of Visit Demographics Department Type of visit (i.e. Initial visit/ phone call, Follow-up) Febrile Respiratory Illness (FRI) Screening results Condition(s) = Syndromes: Gastrointestinal,

Respiratory (Upper/ Lower), FRI, Musculoskeletal, Other

Value of the Integrated System Integration of OH and ED data Novel pilot project Provide early warning of respiratory and

gastrointestinal activity- Enhance active specimen collection- Allow managers to prepare for shortages (surge

capacity)- Enable earlier public health response- Facilitate infection control procedures Improve Communication

Value of the Integrated System Lessons from SARS – electronic/ automated

monitoring of HCWs

Improve communication, collaboration, coordination between Public Health and the Acute Care Sector

Bi-weekly reports

Respiratory-related OH VisitsAll - s_resp

0

5

10

15

20

25

30

35

4/5

/04

5/5

/04

6/5

/04

7/5

/04

8/5

/04

9/5

/04

10

/5/0

4

11

/5/0

4

12

/5/0

4

1/5

/05

2/5

/05

3/5

/05

4/5

/05

5/5

/05

6/5

/05

7/5

/05

8/5

/05

Gastrointestinal-related OH Visits

All - s_GI

0

5

10

15

20

25

11/1/

06

11/8/

06

11/15

/06

11/22

/06

11/29

/06

12/6/

06

12/13

/06

12/20

/06

12/27

/06

1/3/

07

1/10

/07

1/17

/07

1/24

/07

1/31

/07

2/7/

07

2/14

/07

2/21

/07

2/28

/07

3/7/

07

3/14

/07

3/21

/07

3/28

/07

average Alerts

# of Initial GI-related ED visits

Components of Compendium1. Introduction paper – describes the

development and implementation process, with a focus on future uses of the integrated system for public health interventions and pandemic and emergency planning

Components of Compendium2. Norovirus outbreak paper – description of

a Norovirus outbreak that occurred among inpatients at the local hospital

Components of Compendium3. Cost – benefit of the system with a focus

on the impact of vaccination rates among staff and the implications for staff absenteeism and associated costs

Components of Compendium4. Technical Evaluation & Analysis paper –

to describe the process of integrating the data into RODS and an explanation of the anomaly detection used for analysis

Components of Compendium5. System Evaluation – using the Centers for

Disease Control (CDC) Framework for Evaluating Public Health Surveillance Systems for Early Detection of Outbreaks

Components of Compendium6. Spatial analysis of Occupational Health

visit data – a descriptive paper explaining the development and functionality of a 3D mapping tool which tracks Occupational Health visit reporting of respiratory and gastrointestinal-related illnesses

Mapping – Kingston General Hospital

Floor Plan at KGH

Percent Occupational Health VisitsDue to Gastrointestinal IllnessMarch 11th – 17th 2007

Percent Occupational Health VisitsDue to Gastrointestinal IllnessMarch 11th – 17th 2007

> 5%

6% - 10%

> 10%

< 5%

6% - 10%

> 10%

Components of Compendium7. Time-series analysis of weekly average

Occupational Health and Emergency Department visits

How does OH surveillance contribute to Public Health? Automatic, concise details of OH visit activity for

surveillance of unusual health events or disease outbreaks

Monitoring of multiple data sources Enhances communication and collaboration with

appropriate health care professionals and stakeholders Early Warning to facilitate public health response (eg.

increased Infection Control, implementation of emergency plans)

Awareness of absenteeism Facilitate ongoing research

Q Dedicated to enhancing the health and safety of Canadians through public health informatics

Future OpportunitiesNon-Infectious Disease-Related Musculoskeletal monitoring – intervention [i.e. new lift equipment, lift education and

techniques] Needle-stick injury monitoring Staff Absenteeism

Acknowledgements Colleagues – Drs. Kieran Moore and

Jennifer Carpenter QUESST/ QPHI Physician Services Incorporated

Foundation KFL&A Public Health Kingston General Hospital

Thank You Questions?