KFL&A Health Unit: Geospatial EDSS

Geospatial mapping of respiratory and gastrointestinal hospital visit data through a regional, real-time, emergency department surveillance system for Decision Support

and Community Awareness

Interim Report

March 28th, 2008Updated June 11, 2008

Q Dedicated to enhancing the health and safety of Canadians through public health informatics

Outline

• Project overview• Summary of Users & Needs• User Interface Mock-up – Walkthrough• Next Steps

Introduction• Kingston Frontenac and Lennox & Addington (KFL&A) Public Health in

association with the Queen’s University Public Health Informatics (QPHI) Team is undertaking a project to inform health professionals and other members of the community about up-to-date utilization of local Emergency Departments for respiratory and gastrointestinal illness.

• The purpose of the project is to enable informed decision making in the community.

• Reporting of this data on maps showing activity by neighbourhood is expected to allow infection control practitioners, family physicians, community access centers, long term care facilities, schools and child care centers amongst others to know immediately current respiratory and gastrointestinal infectious activity in the community.

Project Vision

“To reduce morbidity and mortality in the community from infectious illnesses by providing the right message to the right people in the right place, at the right time.”

Objectives

1) Limit the spread of disease;

2) Reduce the impact on hospital emergency departments;

3) Save lives among at risk populations (children and elderly); and,

4) Better understand the spread of disease.

Project Overview – Approach & Timelines

Jan 14 –25 Feb 6 – Mar 28 Apr 2 – Jun 30 Jul 11

Initiation & Planning

Initiation & Planning

System Analysis &

Design

System Analysis &

DesignDevelopmentDevelopment Launch

DateLaunch

Date

• Kick-off Project• Develop Project

Charter• Develop Project Plan,

Resource Plan, Communications PlanA

ctiv

ities

Del

iver

able

s

• Project Charter & Project management Plan

• Analyze RODS / EDSS System, Geospatial & aspatial data requirements,

• Validate user needs

• Design complete system

• System Architecture & Design Document

• Develop Database, ETL, GIS and web components

• Develop system documentation

• Integrate system with RODS

• Integrate system with web sites

• GDSS System

• Test System• Make final

modifications• Implement external

communications plan

• Live, publicly available GDSS System (soft launch)

Summary of UsersPublic Health / Healthcare Professionals

– Medical Officers of Health from KFL&A Public Health and HPECHU– PH Nurses (CD, adult, school, dental, infectious diseases)– Local physicians/nurses and hospital administrators– Long Term Care Homes (LTCH) & CCAC– Home care and field professionals (OT/PT, speech therapists, etc.)

Institutions / Institutional Administrators– School board, Schools, Universities, Colleges– Child care– Employers– Police & Fire, all EMS– Municipal officials

General Public– Local citizens– All citizens will have real-time access to geospatial data informing them of respiratory

and gastrointestinal outbreaks and linking them directly to further information, ongoing epidemiological analyses such as viral lab tests (eg. Influenza and RSV results) and results of suspected reportable gastrointestinal diseases.

Ex.1: Public Health: CD Nurses

Important Characteristics• Apt to use RODS/ EDSS, or reports / outputs generated from it• Potential users of GDSS to assist in outbreak investigation

Useful Functions would include:• Ability to interact with map of the health unit, with locations of

institutions (hospitals, LTCs, schools, university & colleges, penitentiaries, large employers, daycares etc.)

• Ability to view attributes of institutions such as school populations, bed censuses and key contacts in the map

Ex.2: Family PhysiciansImportant Characteristics• Overwhelmed with information sources, media & tools• Get a feel for when ‘something is going around’ from diagnostic trends

and discussions with colleagues & variety of other sources

Useful Functions would include:• Ability to confirm assumptions about infection trends in the community

with evidentiary support• Support patient education (“this is where you live, in a hotspot”);

Reinforce behaviours with patients (vaccinations, hand-washing)• Provide a central resource for disease information, case definitions, etc.

(‘take away’ with URL?) for patients• Ability to zero in on hotspot areas• Ability to quick search by postal code

Ex.3: School Board PersonnelImportant Characteristics• Communicate with students and families through newsletters, web site, phone calls from

secretary• High degree of regular interaction in meetings (district, principals, vice-principals)

Useful Functions would include:• Ability to better plan for and predict HR shortages e.g. caused by increased teacher

absenteeism (i.e. supply requirements)• Ability to better inform families about infections affecting school population (“we’re

experiencing an outbreak, keep your ill child at home”)• Provide evidentiary criteria to changes in pandemic status (level 1, 2, 3, 4)• Provide a central resource for disease information, fact sheets, vaccination locations etc., for

students and families• Provide specific information for high-risk groups (e.g. special needs)• Provide links to infectious disease information directly on school and board websites

Ex.4: Community MembersImportant Characteristics• Many media sources competing for attention; web sites are just one

aspect• Want to know when they should stay home, keep children home, teach

prevention to family, learning tool

Useful Functions would include:• Ability to subscribe to e-mail listserv to receive high-level advisories;

follow link to web site for maps and additional information• Ability to become more informed about infections: symptoms,

precautionary information, fact sheets about GI & respiratory infections, recovery periods, etc.

Ex.5: LTCH Infection ControlImportant Characteristics• Receives outbreak info from multitude of sources: reports from 3 local

HUs, LTCHs, RODS output from Tara @ KFL&A, Flu Watch, local news, ProMed

• Information received is “not nearly as quick as one would like”• Maintains list of ongoing outbreaks and distributes to LTCH admitting

teams, ICPs, medical records – tool can provide a ‘heads up’) to those that receive the reports and others in out in the field (OT/PT etc.)

Useful Functions would include:• Ability to incorporate data from additional sources beyond ED, including

all schools, (esp. primary), universities and colleges, inside LTCH, family doctor visits, TeleHealth

Next stepsProject / Development• Complete Review of System Design Specifications• Begin System Development• Refine UI Characteristics• Initiate Integration Planning with KFL&A website

Communications• Engaged HCNSEO (facilitated by Dr. Gemmill)• Full roll-out planned for October (start of flu season)• City wide communication plan (radio, tv, newspaper, press

conference?)