TY - JOUR
T1 - Cloud-Based Influenza Surveillance System in Emergency Departments Using Molecular-Based Testing
T2 - Advances and Challenges
AU - Shaw-Saliba, Kathryn
AU - Hansoti, Bhakti
AU - Burkom, Howard
AU - Martinez, Diego A.
AU - DuVal, Anna
AU - Lee, Brian
AU - Chau, Phong
AU - McBride, Breanna
AU - Hsieh, Yu Hsiang
AU - Sathananthan, Vidiya
AU - Persing, David
AU - Turnlund, Michael
AU - Shively, Roxanne
AU - Dugas, Andrea
AU - Rothman, Richard E.
N1 - Funding Information:
Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The study was supported by US Department of Health and Human Services Biomedical Advanced Research and Development Authority (BARDA) from the Assistant Secretary for Preparedness and Response, Department of Health and Human Services; agreement numbers IDSEP 130014?01?00 and 160031?01? 00). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Assistant Secretary for Preparedness and Response or the Centers for Disease Control and Prevention. In addition, the authors would like to acknowledge the roles of David Persing and Michael Turnlund from the Department of Engineering and Software, Cepheid, Sunnyvale, CA; and Roxanne Shively from BARDA, US Department of Health and Human Services, Washington, DC, in making this work possible. Richard E. Rothman previously served on a Cepheid Advisory Board to evaluate the use of molecular diagnostics in ED settings. Dr. Andrea Dugas contributed to this manuscript in her private capacity. The views expressed in this article/speech do not represent the views of or endorsement by the United States Government or the FDA.
Publisher Copyright:
© 2022 Shaw-Saliba et al.
PY - 2022
Y1 - 2022
N2 - Introduction: Electronic influenza surveillance systems aid in health surveilance and clinical decision-making within the emergency department (ED). While major advances have been made in integrating clinical decision-making tools within the electronic health record (EHR), tools for sharing surveillance data are often piecemeal, with the need for data downloads and manual uploads to shared servers, delaying time from data acquisition to end-user. Real-time surveillance can help both clinicians and public health professionals recognize circulating influenza earlier in the season and provide ongoing situational awareness. Methods: We created a prototype, cloud-based, real-time reporting system in two large, academically affiliated EDs that streamed continuous data on a web-based dashboard within hours of specimen collection during the influenza season. Data included influenza test results (positive or negative) coupled with test date, test instrument geolocation, and basic patient demographics. The system provided immediate reporting to frontline clinicians and to local, state, and federal health department partners. Results: We describe the process, infrastructure requirements, and challenges of developing and implementing the prototype system. Key process-related requirements for system development included merging data from the molecular test (GeneXpert) with the hospitals' EHRs, securing data, authorizing/ authenticating users, and providing permissions for data access refining visualizations for end-users. Conclusion: In this case study, we effectively integrated multiple data systems at four distinct hospital EDs, relaying data in near real time to hospital-based staff and local and national public health entities, to provide laboratory-confirmed influenza test results during the 2014-2015 influenza season. Future innovations need to focus on integrating the dashboard within the EHR and clinical decision tools.
AB - Introduction: Electronic influenza surveillance systems aid in health surveilance and clinical decision-making within the emergency department (ED). While major advances have been made in integrating clinical decision-making tools within the electronic health record (EHR), tools for sharing surveillance data are often piecemeal, with the need for data downloads and manual uploads to shared servers, delaying time from data acquisition to end-user. Real-time surveillance can help both clinicians and public health professionals recognize circulating influenza earlier in the season and provide ongoing situational awareness. Methods: We created a prototype, cloud-based, real-time reporting system in two large, academically affiliated EDs that streamed continuous data on a web-based dashboard within hours of specimen collection during the influenza season. Data included influenza test results (positive or negative) coupled with test date, test instrument geolocation, and basic patient demographics. The system provided immediate reporting to frontline clinicians and to local, state, and federal health department partners. Results: We describe the process, infrastructure requirements, and challenges of developing and implementing the prototype system. Key process-related requirements for system development included merging data from the molecular test (GeneXpert) with the hospitals' EHRs, securing data, authorizing/ authenticating users, and providing permissions for data access refining visualizations for end-users. Conclusion: In this case study, we effectively integrated multiple data systems at four distinct hospital EDs, relaying data in near real time to hospital-based staff and local and national public health entities, to provide laboratory-confirmed influenza test results during the 2014-2015 influenza season. Future innovations need to focus on integrating the dashboard within the EHR and clinical decision tools.
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U2 - 10.5811/westjem.2021.9.52741
DO - 10.5811/westjem.2021.9.52741
M3 - Article
C2 - 35302441
AN - SCOPUS:85126654771
SN - 1936-900X
VL - 23
JO - Western Journal of Emergency Medicine
JF - Western Journal of Emergency Medicine
IS - 2
ER -