Enhanced health event detection and influenza surveillance using a joint Veterans Affairs and Department of Defense biosurveillance application

Cynthia A. Lucero, Gina Oda, Kenneth Cox, Frank Maldonado, Joseph S. Lombardo, Richard Wojcik, Mark Holodniy

Research output: Contribution to journalArticle

Abstract

Background: The establishment of robust biosurveillance capabilities is an important component of the U.S. strategy for identifying disease outbreaks, environmental exposures and bioterrorism events. Currently, U.S. Departments of Defense (DoD) and Veterans Affairs (VA) perform biosurveillance independently. This article describes a joint VA/DoD biosurveillance project at North Chicago-VA Medical Center (NC-VAMC). The Naval Health Clinics-Great Lakes facility physically merged with NC-VAMC beginning in 2006 with the full merger completed in October 2010 at which time all DoD care and medical personnel had relocated to the expanded and remodeled NC-VAMC campus and the combined facility was renamed the Lovell Federal Health Care Center (FHCC). The goal of this study was to evaluate disease surveillance using a biosurveillance application which combined data from both populations. Methods. A retrospective analysis of NC-VAMC/Lovell FHCC and other Chicago-area VAMC data was performed using the ESSENCE biosurveillance system, including one infectious disease outbreak (Salmonella/Taste of Chicago-July 2007) and one weather event (Heat Wave-July 2006). Influenza-like-illness (ILI) data from these same facilities was compared with CDC/Illinois Sentinel Provider and Cook County ESSENCE data for 2007-2008. Results: Following consolidation of VA and DoD facilities in North Chicago, median number of visits more than doubled, median patient age dropped and proportion of females rose significantly in comparison with the pre-merger NC-VAMC facility. A high-level gastrointestinal alert was detected in July 2007, but only low-level alerts at other Chicago-area VAMCs. Heat-injury alerts were triggered for the merged facility in June 2006, but not at the other facilities. There was also limited evidence in these events that surveillance of the combined population provided utility above and beyond the VA-only and DoD-only components. Recorded ILI activity for NC-VAMC/Lovell FHCC was more pronounced in the DoD component, likely due to pediatric data in this population. NC-VAMC/Lovell FHCC had two weeks of ILI activity exceeding both the Illinois State and East North Central Regional baselines, whereas Hines VAMC had one and Jesse Brown VAMC had zero. Conclusions: Biosurveillance in a joint VA/DoD facility showed potential utility as a tool to improve surveillance and situational awareness in an area with Veteran, active duty and beneficiary populations. Based in part on the results of this pilot demonstration, both agencies have agreed to support the creation of a combined VA/DoD ESSENCE biosurveillance system which is now under development.

Original languageEnglish (US)
Article number56
JournalBMC Medical Informatics and Decision Making
Volume11
Issue number1
DOIs
StatePublished - 2011

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Biosurveillance
Veterans
Human Influenza
Joints
Health
Delivery of Health Care
Disease Outbreaks
United States Department of Defense
Population Surveillance
Infrared Rays
Population
Bioterrorism
Environmental Exposure
Weather
Centers for Disease Control and Prevention (U.S.)
Lakes

ASJC Scopus subject areas

  • Health Informatics
  • Health Policy

Cite this

Enhanced health event detection and influenza surveillance using a joint Veterans Affairs and Department of Defense biosurveillance application. / Lucero, Cynthia A.; Oda, Gina; Cox, Kenneth; Maldonado, Frank; Lombardo, Joseph S.; Wojcik, Richard; Holodniy, Mark.

In: BMC Medical Informatics and Decision Making, Vol. 11, No. 1, 56, 2011.

Research output: Contribution to journalArticle

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AU - Holodniy, Mark

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