BioSense 2.0
Current Status, Challenges and Opportunities
CSTE Pre-Conference Workshop
June 9, 2013
Kathleen Gallagher, D. Sc., MPH
Director
Division of Notifiable Diseases and Healthcare Information
Public Health Surveillance and Informatics Program Office
Office of Surveillance, Epidemiology, and Laboratory Services
Public Health Surveillance and Informatics Program Office (PHSIPO, Proposed)
Office of Surveillance, Epidemiology, & Laboratory Services (OSELS)
Discussion Points
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Future funding and budget
Current status and activities
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DUAs
Onboarding
Evaluation activities
Updating C&A
Review of new products
ICD9-ICD10 transition
Current Priorities
Challenges and Opportunities
Questions?
BioSense – Cooperative Agreement Funding
FY 2013
FY 2014
FY 2015
Estimated
Request
Request
35
34
34
$0.196
$0.200
$0.200
$0.100–$0.275
$0.100–$0.300
$0.100–$0.300
0
0
0
35
34
34
$6.871
$7.084
$7.084
(dollars in millions)
Number of Awards
Average Award
Range of Awards
Number of New Awards
Number of Continuing Awards
Total Grant Award
Timeline for Funding Year 2 of BioSense
Cooperative Agreement
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March 15, 2013 - RFA published
May 3, 2013 - Applications due in Grants.gov
June 14, 2013 - Funding recommendations to PGO
August 19, 2013 - NGA sent to grantees
September 1, 2013- Start date for all awards
Status and Current Activities
BioSense 2.0 DUA Status (June 15, 2012)
Signed DUA
New to BioSense, N=13
• Arkansas
• Arizona
• Illinois
• Kansas
• Louisiana
• Montana
• New Jersey
• Tennessee
• Virginia
• Washington
• West Virginia
• San Diego County, CA
• Washington, D.C.
DUA Under Review, N=29
• Alabama
• Alaska
• California
• Colorado
• Connecticut
• Florida
• Georgia
• Kentucky
• Massachusetts
• Maine
• Michigan
Signed DUA
BioSense 1.0 and 2.0, N=4*
• Indiana
• North Carolina
• Ohio
• Tarrant County, TX
Declined for this Year, N=2
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Minnesota
Missouri
North Dakota
Nebraska
New Hampshire
New York
Pennsylvania
Rhode Island
South Carolina
Utah
Vermont
• Wisconsin
• Wyoming
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Boston, MA
Los Angeles County, CA
Montgomery County, MD
New York City, NY
Sacramento County, CA
Engaged in Recruitment
(ongoing outreach to S&L)
Local Public Health
*Out of 8 DUAs in BioSense 1.0.
The other 3 states are anticipated to
sign soon (MI, MO, GA). Cook
County is participating under the IL
DUA. There was no data loss from
1.0 to 2.0, as all data is captured in
the CDC locker.
BioSense 2.0 Signed Data Use
Agreements
N=44
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May 29, 2013
Alabama
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Alaska
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Arizona
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Arkansas
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Florida
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Illinois
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Indiana
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Kansas
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Louisiana
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Maine
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Maryland
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
Ohio
Pennsylvania
Rhode Island
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Boston, MA
Denver, CO
El Dorado Co., CA
Houston, TX
Marion Co., IN
New York City, NY
Sacramento Co., CA
San Diego, CA
Tarrant Co., TX
Washington, D.C.
BioSense 2.0 Data by State
N=28
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May 29, 2013
Alabama (2 of 101)
Alaska (1 of 20)
Arizona (8 of 70)
California (13 of341)
Colorado (5 of 83)
Illinois (50 of 193)
Indiana (107 of120)
Kansas (28 of 131)
Louisiana (38 of 113)
Maine (26 of 37)
Maryland (1 of 48)
Massachusetts (11 of 73)
Missouri (77 of 119)
Montana (3 of 58)
Nevada (15 of 33)
New Mexico (9 of 37)
New York (1 of 199)
North Carolina (119 of
119)
Ohio (176 of 189)
Pennsylvania (119 of 171)
Rhode Island (7 of 10)
Texas (72 of 439)
Utah (38 of 46)
Virginia (7 of 96)
Washington (19 of 95)
Washington, DC (4 of 8)
West Virginia (5 of52)
Wisconsin (46 of 126)
Updating C&A
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Originally approved by CDC November 2011
Needs to be updated to incorporate all changes to
the BioSense 2.0 environment
Needs to comply with FedRamp requirements re:
cloud environments
 ( waiting for guidance on how to do this)
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Current environment continues to operate as is while
updated submission is being prepared and reviewed
Opportunity for incorporating other changes to the
environment
Process for Review of New Products, Priorities
and Functions
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Established weekly internal “feature” review
 Requests from all stakeholders
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Establish process for reviewing requests from
BioSense governance (or others?)
 Newly formed PHSIPO IT governance and review process
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Product Review
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Technical design and architecture
Data exchange and integration
Security/ Privacy
Cost/ Licensing
Functionality (analytic capacity, data coding)
Current Priorities ( next 1-2 years)
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Onboard ED data from all participating jurisdictions
Onboard national lab and pharmaceutical sales data
and enable these data to be shared with participating
state and local PH jurisdictions
Expand sharing of data in BioSense environment
between state and local health jurisdictions
Develop robust and objective process for evaluating
( and adding ) analytical and visualization products
for use in the BioSense environment
Increase the utility for CDC of data from BioSense
2.0 to describe and monitor all hazards situational
awareness at the national level
Evaluation Activities
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Evaluation with key external stakeholders (RTI)
 will assess the performance, use, utility, usability, and costs of
the system as well as the onboarding experience. The evaluation
is intended to guide the Governance Group, CDC, state, local,
and territorial (STLT) stakeholders and the RTI BioSense
Redesign team in their deliberations and decisions about the
development of BioSense 2.0.
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CDC Internal Evaluation
 to ensure the whole of the BioSense program will meet its goals
and demonstrate its value to public health, an internal evaluation
is warranted to explore current issues and identify key activities
that will realize the program's objectives.
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BioSense 2.0 Challenges
• Capacity ( internal and external)
– Analytic ( Big data, switch from SAS to R)
– Community of Practice
• Coordination
– Multi-dimensional project with many“ moving parts” with many
intersections and interfaces
– Technical, legal, policy, security, programmatic considerations
• Communication
– Promoting utility to cynics
– Managing expectations of advocates
• Onboarding Data
– This is a rate-limiting step
• Operationalizing the sharing of data across
jurisdictions/owners
BioSense 2.0 Opportunities
– Expand data use to include non-infectious
conditions (e.g, MI, injury)
– Explore other sources of data ( weather, EMS,
social media)
– MUse Stage 3 for outpatient & inpatient facilities
– Expand coverage and representativeness of
participants
– Expand Community of Practice
• Including other federal partners?
Thank you
For more information please contact Centers for Disease Control and
Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
E-mail: cdcinfo@cdc.gov Web: www.cdc.gov
ASTHO and CDC Building BioSense 2.0
June 2011 – June 2012
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Governance
 ASTHO established an interim S&L governance structure
 Meeting every other week since early winter
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Establishing BioSense 2.0 Cloud
 ASTHO identified Amazon Web Services as the Cloud vendor of choice
 Worked with BioSense redesign team to set up cloud environment
 BioSense 1.0 retired April 2012
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BioSense 2.0 Open for Business
 S&L HDs can initiate or expand their syndromic surveillance systems
under the MUse program for their own jurisdiction
 CSTE started recruitment in coordination with ASTHO, NACCHO, CDC,
and ISDS (67 jurisdictions)
 Stakeholders begin collaborating among themselves and CDC in new
environment governed by data use agreements established with
ASTHO
 CDC BioSense 2.0 Funding Opportunity proposals due June 26
ASTHO and CDC Building BioSense 2.0
Next steps
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June 2012: Establish permanent governance
structure
July 2012: Award BioSense 2.0 cooperative
agreement
 $7 million for up to 35 sites
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December 2012: Demonstrate examples of data
sharing
October 2013: 32 DUAs signed
June 2014: Redesign complete
OSELS Current Priority Initiatives
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Increase use of electronic health records as part of
an integrated system for public health surveillance
Improve public health data access, analysis,
interpretation, and communication
Develop an efficient, sustainable and integrated
network of public health laboratories
Prepare the public health workforce to meet 21st
Century challenges