James W. Buehler, MDDirector, Public Health Surveillance Program Office,

OSELS, CDC

CSTE Annual ConferenceJune 13, 2011Pittsburgh, PA

Public Health Surveillance Program Office:

Surveillance Challenges & Opportunities

Office of Surveillance, Epidemiology, and Laboratory Services

Public Health Surveillance Program Office

Public Health Surveillance Program Office (PHSPO)

Who we are What we do Surveillance challenges &

opportunities

PHSPO: Established in 2010Part of the Office of Surveillance,

Epidemiology & Laboratory Services (OSELS)

From the (former) National Center for Public Health Informatics National Notifiable Diseases Surveillance

System• NEDSS, NETSS, NBS

BioSense Program CDC lead for Distribute Assessment Initiative

From the National Center for Chronic Disease Prevention & Health Promotion Behavioral Risk Factor Surveillance System

(BRFSS)

PHSPO: Established in 2010

From the (former) COTPER now Office of Public Health Preparedness & Response BioSurveillance Coordination Unit

• National Biosurveillance Advisory Subcommittee • National Biosurveillance Strategy for Human Health• Federal & SLTT workgroups• Surveillance & Biosurveillance Registry

From the CDC Office of the Associate Director for Science Surveillance Science Advisory Committee

(SurvSAG)

Activity & Division Leads

Partnerships & Planning Activity: Dr. Pamela Meyer

Biosurveillance Coordination Activity: Dr. Pamela Diaz

Division of Behavioral Surveillance: Dr. Frederic Shaw (Acting)

Division of Notifiable Diseases & Healthcare Information Dr. Kathleen Gallagher

What We Do

Mission: To advance the science & practice of public health surveillance

Manage several large surveillance systems with cross-CDC utility Two broad perspectives: Information arising from

• Healthcare encounters• Population health surveys

Most surveillance activities/systems & resources elsewhere at CDC

“Home” for surveillance at CDC Address surveillance issues of concern &

interest to epidemiologists and users of surveillance information

What We Do Fulfill expectations in creation of OSELS

Add epidemiologic & statistical capacity Establish new identity, cohesion, & culture

Keep the trains running Address unfinished business & unfulfilled

expectations Adapt to, embrace, & anticipate changing

landscape How we use telephones and other media to communicate Expanding use of electronic health records Advances in information technology & discipline of

informatics New expectations

Mental health surveillance (inc. Gulf survey) Surveillance of the use of preventive healthcare services

How should we involve city/county epidemiologists in conversations about the future of surveillance ? Often have front-line responsibility for public health

surveillance Substantial expertise & interest in surveillance Substantial contributions to innovation NACCHO role

0 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45 480

5,000,00010,000,00015,000,00020,000,00025,000,00030,000,00035,000,00040,000,000

Population of States & 50 Largest US Counties

States (smallest to largest) 50 Counties (largest to smallest)

Popula

tion

Source: 2009 mid-year population estimates, www.census.gov

Meaningful Use & Healthcare ReformOpportunity & Challenges

Opportunity: Strong alignment of clinical & public health objectives

Challenge: Will public health be ready? Population health measures

Laboratory test results Immunizations Syndromic surveillance

• What is need & use beyond current SS capacity• Least familiar to physicians• New option for BioSense support to states capacity to

absorb & use

Defining future PH measures What is our role in healthcare services

monitoring? How will we know if meaningful use is

working?

Where’s the Meaningful Use Train?

Image source: www.tripadvisor.com and Eurostar

Mosaic of surveillance: Role & intersection of complementary surveillance systems

Relevance of nationally notifiable condition paradigm?

Indicators, Indicators, Indicators Accreditation Community health assessments ACA mandate to non-profit hospitals

Health Data Community: www.healthdata.gov

Make effective use of our $s Demonstrate & communicate the value of

what we do

Issues here & now & on horizon

What doesn’t change

Meeting a need for information Making effective use of that

information CSTE-CDC Partnership

For more information please contact Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: cdcinfo@cdc.gov Web: www.cdc.gov

The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Thank you

Office of Surveillance, Epidemiology, and Laboratory Services

Public Health Surveillance Program Office