Information technology for surveillance Can information tools improve surveillance

1
Information technology for surveillanceCan
information tools improve surveillance?

• Denis CoulombierECDC

2
New information technologiesThe technology
paradox

• A new technology may have a negative impact on
  productivity if used without a change of approach
• New technologies require a change of practices
  to give their full benefit

3
The technology paradoxExamples
4
Pre computer ages
5
The technology paradoxHow it applies to
information?
Epiinfo 1, 1985
Epiinfo 2/3, 1987
Epiinfo 6, 1994
From data compilation
to decision-making
6
Information technologies anddata collection

• Benefit
• Computerised data entry
• Fast data transfer
• Structured data
• Prerequisites
• Case definitions
• Appropriate data models

7
Information technologies anddata analysis

• Benefits
• Fast compilation
• Computation of indicators (rates, standardized
  rates)
• Thresholds
• Prerequisites
• Appropriate hypotheses
• Defined plan of analysis

8
Information technologies anddata presentation

• Benefits
• Tables, maps and charts
• Automated reports
• Prerequisites
• A guide to data review
• A decision-making approach

9
The Serbia Alert Project

• March 2003
• Request to WHO to computerised the early warning
  system
• 73 diseases under mandatory notification
• 20 agegroups
• Monthly aggregation at national level
• No computerized analysis

10
The Serbia Alert Project

• May 2003 in-depth assessment
• Need for prioritization of CD under early warning
  surveillance workshop
• Need for syndromic case definitions
• Need for guidelines on investigation and control
  measures
• Need for change in surveillance regulations

11
The Serbia Alert Project Strengthening Strategy
A structured and integrated approach to
epidemiologicalsurveillance and response
strengthening
Risk assessment
Monitoring andevaluation
Prioritization
In-depthassessment
Implementation
Plan of action
12
The Serbia Alert Project Risk Assessment

• Public health risks change over time
• Emerging and re-emerging diseases
• Changes in epidemiological profile
• New strains (meningitis W135)
• Antibiotic resistance
• Advanced technology, improved knowledge
• New vaccines, control programmes
• Demographic changes
• Environmental changes
• Output risk assessment fact sheets

13
Risk Assessment Fact Sheets
14
Prioritization of Communicable Diseases

• Changing risks and priorities
• Limited human and financial resources
• Priority to diseases of public health importance
• Short list of diseases for efficiency
• Consensus process
• 3 day workshop
• Output list of priorities for surveillance and
  EWARS

15
PrioritizationReaching a Consensus on Priorities
16
Assessing National Capacities for Surveillance
and Response

• In-depth assessment helps to identify
• Strengths and weaknesses of a system
• Meeting the priorities identified
• Areas for improved coordination
• Areas for integration
• Ways for improvement
• Baseline information to allow measurement of
  progress
• Output assessment report and
  recommendations

17
Development of National Surveillance PoA

• Objective Effective national multi-diseases
  (integrated) system with an early warning
  component
• Involvement of key stakeholders in surveillance
• Ensuring coordination
• Prioritized strategic plan (3-5 years) with
  annual operational plans
• Costing and identification of funding source
• Output a framework in which donors and partners
  can buy in

18
Implementation of EWARS

• Prerequisites to implementation of EWARS
• Defining functional specifications EWARS core
  functions
• Defining technical specifications EWARS support
  functions
• Defining the implementation plan
• Implementing EWARS
• Output an efficient early warning system

WHO Guidelines on Implementation of National
Early Warning and Response Systems EWARS
June 2004
19
(No Transcript)
20
(No Transcript)
21
(No Transcript)
22
(No Transcript)
23
(No Transcript)
24
(No Transcript)
25
(No Transcript)
26
(No Transcript)
27
(No Transcript)
28
(No Transcript)
29
(No Transcript)
30
(No Transcript)
31
(No Transcript)
32
Reporting districts by WeekEarly Warning System
in Albania, 2000
33
Conclusion

• Information technologies are just tools!
• If not part of a strengthening process, they will
  fail in improving the early warning function
• Monitoring and evaluation is required