What to Consider When Using BioSense 2.0

What to Consider When Using
BioSense 2.0
Bill Stephens
NACCHO Advanced Practice Center
Tarrant County Public Health TX
• 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
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:
Why using BioSense
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
– 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
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
• Response protocols – Essential to buy-in from
staff and partners and must be locally focused
• Tarrant County Biosurveillance Compendium:
– Training and exercise materials
– Community building materials:
Federal partners
First Responders
Medical Community
HIPAA guidance
How to implement Syndromic Surveillance
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
– 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
Bill Stephens
Tarrant County Public Health Advanced Practice Center
(817) 321-4730
[email protected]
For more resources, go to apc.naccho.org
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