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Q Dedicated to enhancing the health and safety of Canadians through public health informatics Queen’s University Public Health Informatics (QPHI) Team QPHI Introduction Dr Kieran Moore June 13thth 2008 Centre for Studies in Primary Care Department of Family Medicine/Emergency Medicine www.quesst.ca QPHI Agenda Relax! Discussion! Feedback! Share ideas! Review Projects! Future Direction Follow up in September Thanks to… Department of Family Medicine and the CSPC Physician Services Incorporated Foundation Ministry of Health and Long Term Care KFLA Public Health-Queen’s University Bank of Nova Scotia Partners Community Health and Epidemiology TEAM…and associates Tara Donovan Adam Van Dyke Jeff Aramini Glenn Guthrie Dillan Fernando Alex Perry Elizabeth Rolland Andrew Kurc Jaelyn Caudle QPHI Enhancing the health of Canadians through Public Health Informatics Analysis of electronic data sets for real time enhanced surveillance-dashboard Multiple disciplines-Computer Engineer and software,Mathematics, Epidemiology, Geography Public Health Astute clinician Laboratory System-Reportable Diseases Passive system…needs to be activated Speed of a 747 Active Surveillance 6 Potential Strategies for Early Detection Number of People 20000 18000 16000 14000 12000 10000 8000 6000 4000 2000 0 -2 -1 Onset of Symptom s Specific Syndrome Deaths 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Intel Biosensors Lab results, X-Rays, etc. Demographics, Chief Complaint, Visit Data Courtesy: Michael Wagner, MD, University of Pittsburgh Siemens Confidential: ©2002 Siemens Medical Solutions Health Ser vices Corporation. Vital statistics and Coroner data Data Options for Surveillance Telehealth Work-school Absenteeism (i.e. Occupational Health) Over-theCounter Sales Primary Care Clinic Lab test Emergency Dept Meat and tomatoes… QPHI-CSPC Projects Acute Care Enhanced Surveillance MOHLTC Occupational Health July 1 2008 Telehealth- December2007 Pharmacy Surveillance August 15 Primary Health Care PHAC Geoconnection ASSET CRTI CCC Telehealth Respiratory Calls (3 day MA) and Respiratory Virus isolates (x3) 3500 All Resp Flu A RSV 3000 2500 Flu B PIV Flu A or B Adeno 2000 1500 1000 500 6/ 1/ 20 06 4/ 1/ 20 06 2/ 1/ 20 06 12 /1 /2 00 5 10 /1 /2 00 5 8/ 1/ 20 05 6/ 1/ 20 05 4/ 1/ 20 05 2/ 1/ 20 05 12 /1 /2 00 4 10 /1 /2 00 4 8/ 1/ 20 04 6/ 1/ 20 04 0 Additional in the works… Virological self sampling Enabled through telehealth as per DL Cooper et al. Cooper et al 292 callers sent kits 42 percent returned 16.2 % PCR positive Influenza 7.4 days between call and lab analysis Earliest reports of the season CODIGEOSIM …geosimulation tools for simulating spatial temporal spread patterns and evaluating health outcomes of communicable disease Dr Rosenberg, Dr Chen, Dr Moore Multi site-York, Laval, Queen’s McMaster 5 universities, 22 researchers Lymes, West Nile and Influenza CODIGEOSIM ) the creation of mathematical models, environmental models, mobility models, population risk models, and dynamic simulation tools to explore the spatiotemporal spread patterns and optimal control measures for a variety of communicable diseases; 2) the dynamical modeling, analysis and simulation, visualization and evaluation of the vulnerability and responses of different communities to the potential outbreak of emerging or reemerging communicable diseases and the effectiveness of corresponding human intervention measures; 3) the development of geosimulation and decision support systems for public health officers that integrate the aforementioned models, data and information, and enable what-if analyses through the specification of various kinds of scenarios such as climate/environmental change, host mobility and intervention plans. PHL…started Resp pathogen data regionally from PHL Data analysis temporally and spatially 4 years of data to detect if there is a “normal” spatial spread for influenza specifically Effect of vaccine efficacy / mismatch on temporal and spatial spread Dr Majury…and a RA CPCSSN-feasibility PHAC Canadian Primary Care Sentinel Surveillance Network for Chronic Disease 7 networks across Canada EMR surveillance Long term tracking 5 major illnesses: Depression, Hypertension, Diabetes, Osteoarthritis, COPD Andrew Kurc FHT and Public Health-funded MOHLTC Evaluation of the integration of Public Health and family health teams Both are tasked with Health Promotion and disease prevention Integrated, evidence based approaches Cooperation and Coordination NRC ASSET project-Advanced Syndromic Surveillance and Emergency Triage Glenn providing technical support and analysis Kieran providing ED/SS support Geoconnections: Infectious Disease Simulation Tool-A Geospatial Decision Support System Peel Public Health U of Waterloo QPHI SAS Canada ISDS Raleigh North Carolina December 2-5th 2008 Submissions now! 3 tracks Future ESSENCE collaborations Consultations? Grant ideas …..Jeff Telehealth – All Respiratory Calls (3 day MA) 800 700 600 500 400 300 200 100 0 6/1/2004 8/1/2004 10/1/2004 12/1/2004 2/1/2005 4/1/2005 6/1/2005 8/1/2005 10/1/2005 12/1/2005 2/1/2006 4/1/2006 6/1/2006 Telehealth Respiratory Calls (3 day MA) and Flu A isolates 800 All Resp 700 600 Flu A isolates 500 400 300 200 100 0 6/1/2004 8/1/2004 10/1/2004 12/1/2004 2/1/2005 4/1/2005 6/1/2005 8/1/2005 10/1/2005 12/1/2005 2/1/2006 4/1/2006 6/1/2006