What to Consider When Using
BioSense 2.0
Bill Stephens
NACCHO Advanced Practice Center
Tarrant County Public Health TX
Overview
• Identify your experience
• Consider important questions
• Focus on the setup model
– Good communication
– Identify roles
• Resources
Identify Your Experience
• Sites new to Syndromic Surveillance
• Sites with Syndromic experience
• More than we can go over today in detail, but
NACCHO has a self assessment survey to help
start asking the right questions and begin
planning:
http://naccho.us.qualtrics.com/SE/?SID=SV_8oAIIfcuxjsgNJq
New Sites
• Consider:
– Why you are using BioSense 2.0
– Workforce/personnel required
– State and local roles (not system based security
roles, but main responsibilities)
– Hospital agreements and ASTHO agreement
– Data flow (Hosp to HD to Cloud, Hosp to Cloud,
Permutations within cloud (i.e. BioSense,
ESSENCE, etc.))
– Permissions and system based security roles
Experienced Sites
• Revisit:
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Why using BioSense
Workforce/personnel
State and local roles (not security roles, but main responsibilities)
Hospital agreements
Data flow (Hosp to HD to Cloud, Hosp to Cloud, Permutations within
cloud (i.e. BioSense, ESSENCE, etc.))
– Permissions and system roles
• Consider:
– Business process redesign
• Take into account:
– maintaining multiple systems (i.e. defining the purpose of each)
– End user retraining
– Partner education/communications about changes
Model Setup
• Have to Consider:
– Technical AND
– Business or Practice issues
• Options:
– Centralize
– Regionalize
– Localize
Technical Model Considerations
• Does the LHD have technical personnel to
manage data feeds?
• Does the Region have technical personnel to
manage data feeds?
• Does the State have technical personnel to
manage data feeds?
• Don’t forget about CDC technical resources
Tarrant County Results
• Key Lessons Learned
– Establishing connectivity is easy, utilizing hardware VPN
routers and MIRTH data integration solutions for LHDs and
hospitals.
– Establishing proper locker configuration based on actual
jurisdictional authority needs clear specification in the
earliest phases where state may not be the sole access
controlling authority
– Data validation compared to local or regional baseline
system or analytical verification tools expedites BioSense
2.0 validation process
– Segmentation of user groups into two broad categories
essential for use-case development and training- new or
experienced users.
– As usual, one size BioSense implementation does not fit
all.
Tarrant County Technical Model Best Practices
• Obviously not every State, Regional, and Local
environment will fit. But we’ve found success:
– Regional model supported by local context
– Enhance local capacity
– State plays more of a supporting and encouraging
role and coordinating regions to be effective
network across the state
• very important and nice for a state the size of TX –
would be difficult for state staff to support whole state
Business/Practice Model Considerations
• “Natural Cooperation” based on daily existing
relationships with hospital staff (i.e. IPs)
• Data quality – Context counts and locals have it
• Anomaly (DQ or event) detection requires good
communication and interoperability with
partners – often best through local
relationships
• Response protocols – Essential to buy-in from
staff and partners and must be locally focused
Resources
• Tarrant County Biosurveillance Compendium:
– Training and exercise materials
– Community building materials:
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Federal partners
First Responders
Medical Community
Schools
HIPAA guidance
How to implement Syndromic Surveillance
Literature
Response Protocols
• CDC Technical Support
• ASTHO staff convene governance over shared resources in the cloud
• NACCHO and CSTE staff can foster peer to peer assistance, create best
practice documentation, and foster regional communities of practice
• ISDS provides the Syndromic Surveillance Community of Practice, research
and innovation, Meaningful Use guidance, and a NACCHO sponsored
Syndromic 101 course
Final Thoughts
• Re-enforce hybrid model – Region and local focused surveillance
that meets minimal standards that enhance the sharing across
jurisdictions
– Overall fits way HIT is evolving – i.e. regional HIEs that are stitched
together across the state and all talking over interoperability standards
• Next steps of the pilot is to work with key informants
– Developing use cases specific to the new BioSense platform – how do
we get this new tool into routine Epidemiology and practice?
– Translating between state perspective and local perspective
• Coordinating interventions
• Provide value for hospitals and providers
• For those who want more details, Our partners at ASTHO and RTI
will be hosting webinars on “Transport” and “Security” for BioSense
2.0 – look for those in the next two weeks
Questions?
Bill Stephens
Tarrant County Public Health Advanced Practice Center
(817) 321-4730
wfstephens@tarrantcountytx.gov
For more resources, go to apc.naccho.org