How will BioSense 2.0 add value to the work of my health department?
Initially, BioSense 2.0 can provide four main benefits to health departments, including:
The BioSense 2.0 will have a menu of services with tremendous capacity to receive, process, and store data. Moreover, it’s entirely possible to participate even if you do not use BioSense 2.0 for primary data collection from Meaningful Use clinical providers. BioSense 2.0 can also serve as your agency's "catcher's mitt" for the volume of new health data incentivized under CMS's Meaningful Use programs, thereby saving your agency from purchasing and maintaining additional servers or other infrastructure required for managing an increased data volume. Once in the BioSense 2.0 environment, your agency can choose to share your jurisdiction's aggregate or record-level data with other local, state, or federal health officials, thereby enhancing situation awareness for public health response.
Why should we invest in syndromic surveillance when we don’t have evidence that it work?
Actually, significant evidence shows that syndromic surveillance does work, both within peer-reviewed literature and as evidenced by its widespread adoption among local and state health authorities. Like any surveillance methodology, syndrome-based surveillance supports situational awareness and public health response in concert with many other information sources (see references below). It serves as an additional public health surveillance tool, with limitations that must be considered when interpreting its findings.
o Buehler et al. (2009). Situational uses of syndromic surveillance. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, & Science, 5:165
o Rappold et al. (2011). Peat bog wildfire smoke exposure in Rural North Carolina is associated with cardio-pulmonary emergency department visits assessed through syndromic surveillance. Environmental Health Perspectives, http://ehp03.niehs.nih.gov/article/info%3Adoi%2F10.1289%2Fehp.1003206
o Baer et al. (2011, March). Usefulness of syndromic data sources for investigating morbidity resulting from a severe weather event. Disaster Medicine and Public Health Preparedness. 5(1):37-45.
o McKenna et al. (2003, September-October). Local collaborations: development and implementation of Boston’s bioterrorism surveillance system. Journal of Public Health Management & Practice, 9(5):384-393.
Is BioSense 2.0 going to help us be more prepared? Has there ever been a big outbreak that BioSense or another syndromic surveillance system detected before an astute clinician?
BioSense 2.0 will enhance situation awareness through greater epidemiological capability. Although state-of-the-art functions and tools will be provided in the new BioSense environment, technology alone is not enough. Data quality, data representativeness, and epidemiological competencies are critical factors that will determine the sensitivity and specificity of BioSense 2.0. Although the original goal of syndromic surveillance was rapid outbreak detection, most public health professionals now find this surveillance approach provides considerable value for situation awareness, or monitoring and projecting changes in population health (see references below). During the 2009 influenza pandemic, the Distribute project (http://isdsdistribute.org), in collaboration with BioSense, rapidly connected existing syndromic surveillance systems across the United States to provide near real-time coverage of over 40% of emergency department visits in the country. State and local public health departments used the Distribute system to understand the progression of disease in neighboring regions, while CDC used the system to provide a timely regional or national picture.
o Buehler et al. (2008) Syndromic surveillance practice in the United States: findings from a survey of state, territorial, and selected local health departments. Advances in Disease Surveillance, vol. 6 (3) pp. 1–20.