BMC Med Inform Decis Mak - Enhanced health event detection and influenza surveillance using a joint Veterans Affairs and Department of Defense biosurveillance application.

Tópicos

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Resumo

CKGROUND: The 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.METHODS: A 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.RESULTS: Following 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.CONCLUSIONS: Biosurveillance 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.

Resumo Limpo

ckground establish robust biosurveil capabl import compon us strategi identifi diseas outbreak environment exposur bioterror event current us depart defens dod veteran affair va perform biosurveil independ articl describ joint vadod biosurveil project north chicagova medic center ncvamc naval health clinicsgreat lake facil physic merg ncvamc begin full merger complet octob time dod care medic personnel reloc expand remodel ncvamc campus combin facil renam lovel feder health care center fhcc goal studi evalu diseas surveil use biosurveil applic combin data populationsmethod retrospect analysi ncvamclovel fhcc chicagoarea vamc data perform use essenc biosurveil system includ one infecti diseas outbreak salmonellatast chicagojuli one weather event heat wavejuli influenzalikeil ili data facil compar cdcillinoi sentinel provid cook counti essenc data result follow consolid va dod facil north chicago median number visit doubl median patient age drop proport femal rose signific comparison premerg ncvamc facil highlevel gastrointestin alert detect juli lowlevel alert chicagoarea vamc heatinjuri alert trigger merg facil june facil also limit evid event surveil combin popul provid util beyond vaon dodon compon record ili activ ncvamclovel fhcc pronounc dod compon like due pediatr data popul ncvamclovel fhcc two week ili activ exceed illinoi state east north central region baselin wherea hine vamc one jess brown vamc zeroconclus biosurveil joint vadod facil show potenti util tool improv surveil situat awar area veteran activ duti beneficiari popul base part result pilot demonstr agenc agre support creation combin vadod essenc biosurveil system now develop

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