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SIREN and MEDSIS

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SIREN (Secure Integrated Response and Electronic Notification system) is the ... SIREN allows for secure alerting (through redundant means), information ... – PowerPoint PPT presentation

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Title: SIREN and MEDSIS


1
Arizonas Public Health Information Infrastructure
  • SIREN and MEDSIS
  • AZ HIMSS - July 23, 2004
  • John Nelson
  • Ken Komatsu

2
Arizona Public Health Information Infrastructure
  • Public Health IT initiatives
  • Arizona Health Alert Network
  • SIREN system infrastructure and features
  • Disease surveillance in Arizona
  • MEDSIS features
  • MEDSIS and hospital systems

3
CDC and Arizona initiatives
CDC AZ
Health Alert Network HAN, Secure Integrated Response Electronic Notification System (SIREN)
National Electronic Disease Surveillance System Medical Electronic Disease Surveillance Intelligence System (MEDSIS)
Laboratory Response Network Laboratory Response Network
Epidemiology Information Exchange (Epi-X) Epidemiology Information AZ (Epi-AZ)
4
PHIN Public Health Information Network Vision
  • To transform public health by coordinating its
    functions and organizations with information
    systems that enable
  • real-time data flow
  • computer assisted analysis
  • decision support
  • professional collaboration
  • rapid dissemination of information to public
    health, clinical care, and the public

Adapted from John W. Loonsk, M.D. Associate
Director for Informatics, CDC
5
PHIN Public Health Information Network
  • Provides a unified information technology
    framework and standards for public health
    informatics
  • Endorses additional integration of public health
    systems in development of an interoperable
    network to support multiple public health
    activities

6
Health Alert Network
  • A state-wide system for health alerting of public
    health, public safety, and health care
    professionals
  • SIREN (Secure Integrated Response and Electronic
    Notification system) is the centerpiece of
    Arizonas Health Alert Network
  • SIREN allows for secure alerting (through
    redundant means), information dissemination, and
    document sharing
  • SIREN also acts as a back-bone to several
    emergency response computer applications,
    including MEDSIS (Medical Electronic Disease
    Surveillance and Intelligence System)

7
Arizona Health Alert Network SIREN System
Infrastructure
  • High Availability
  • Low Maintenance (no client connections to
    support)
  • Scaled to meet existing and proposed 5 year needs
    (3000 4000 simultaneous users)
  • No Major Changes needed to address scaling the
    system

8
Arizona Health Alert Network SIREN
Infrastructure Diagram
9
Arizona Health Alert Network SIREN System
Features
  • The SIREN system infrastructure is designed to
    support various applications and services
  • Security and system authentication
  • Directory services (Public Health Directory)
  • Secure data transfer (messaging)
  • Automated alerting by roles
  • Document management/portal interface
  • Conference bridge/telephony integration
  • Email services

10
Leveraged Services
11
Common Application Platform
12
Data Exchange/Messaging
13
Arizona Health Alert Network SIREN System
Gateway
14
Arizona Health Alert Network SIREN Alert
Notification
  • During an emergency situation, alert
    notifications would be handled via
  • Telephone
  • Facsimile
  • Email
  • Pager notification
  • Web-page updates

15
Arizona Health Alert Network SIREN Alert
Notification
16
SIREN Summary
  • Secure web-based extranet
  • Services based architecture
  • Supports additional applications
  • Provides messaging and notification services

17
MEDSIS
18
Public Health Surveillance
  • Disease surveillance
  • Reporting required by Arizona Administrative Code
    R9-6-201 to 203
  • Required reporting by physicians, hospital
    administrators and clinical laboratories
  • Syndromic surveillance
  • Pre-diagnostic, early warning, real time
  • Existing electronic data
  • reassurance

19
Public Health Surveillance
20
Disease Surveillance
  • Past
  • Paper-based reporting relying on mail, fax and
    phone calls
  • Unable to detect disease outbreaks at earliest
    point of potential recognition
  • MEDSIS
  • Secure, web-based application that allows for
    immediate notification of public health of
    reportable diseases and potential outbreaks

21
Pre-diagnostic Surveillance
Work/schoolabsence
onset
death
22
Pre-diagnostic Surveillance
Work/schoolabsence
onset
death
Over the counter medication
23
Pre-diagnostic Surveillance
Work/schoolabsence
onset
death
Over the counter medication
Nurse Call line
24
Pre-diagnostic Surveillance
Work/schoolabsence
onset
death
Over the counter medication
Nurse Call line
Urgent care visit
25
Pre-diagnostic Surveillance
Lab orders
Work/schoolabsence
onset
death
Over the counter medication
Nurse Call line
Urgent care visit
26
Pre-diagnostic Surveillance
Lab orders
Work/schoolabsence
onset
death
Over the counter medication
ED visit
Nurse Call line
Urgent care visit
27
Pre-diagnostic Surveillance
Lab orders
Work/schoolabsence
EMSrun
traditional sources
onset
death
Over the counter medication
ED visit
Nurse Call line
Urgent care visit
28
  • MEDSIS represents Arizonas tie-in to the
    National Electronic Disease Surveillance System
    (NEDSS), proposed by CDC, and funded through
    Bioterrorism
  • MEDSIS is the system that addresses Governor
    Napolitanos Homeland Security Action Item 8
    Electronic Disease Surveillance

29
MEDSIS is
  • Not a state system
  • a system funded and supported by the state for
    local health department infectious disease
    surveillance.
  • a flexible, expandable system
  • Exceeds HIPAA security standards

30
MEDSIS specifications
  • Uses MS SQL server
  • Written in .Net
  • Integrated into the SIREN infrastructure
  • Meets PHIN specifications
  • Uses the Public Health Logical Data Model (based
    on the HL7 RIM)

31
MEDSIS Data model
Person
Organization
Reporter
Public Health
Public Health Case
Patient
Laboratory
Risk factors
Investigator
Provider
Lab results
Case details
Clinical information
32
MEDSIS Impact
  • Timely receipt of disease reports
  • Increase in disease reports
  • Less data entry of incoming reports
  • Better data quality
  • Simultaneous County/State access
  • Facilitates monitoring trends and analyses
  • Access to alternative surveillance data

33
MEDSIS Design Functionality
  • A browser is the only required software
  • Role-based access and rights to data
  • Ability to analyze data across diseases
  • Ability to query and download or cut and paste
    report data into Excel
  • Moving towards automated geocoding

34
Key Features of MEDSIS
  • Web-based reporting by infection control
    practitioners
  • System-to-system data exchange for laboratory
    reporting (ELR)
  • ELR data instantly available to county/tribal
    health departments
  • Moving towards distributed administration
  • SSL security for application access

35
MEDSIS pilot
  • The initial system was built to replace current
    DOS-based state system
  • Initial pilot testing group is providing feedback
    on the data flow, ease of use, bugs, reports,
    data elements, access issues and policy
    guidelines regarding system use.

36
User
Organization
Role
37
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41
MEDSIS - Analysis
  • Automated Analysis Systems
  • Early Aberration Recognition System (EARS)
  • Spatial Analysis
  • ARC-IMS Geographical Information System
  • SaTScan Space and Time Cluster Analysis

42
Pre-diagnostic Surveillance
  • Mesa EMS run data
  • National Retail Drug Monitoring System Over the
    Counter Pharmaceutical Sales
  • BioSense VA, Drug Sales, Military Hospitals
  • National Systems
  • BIDS Border Infectious Disease Systems
  • SDN CDC Secure Data Network

43
MEDSIS 2004
  • Pilot electronic data exchange with hospital and
    clinical laboratories
  • Add line list reports and extracts
  • Pilot system with counties and infection control
    practitioners
  • WNV module to include human and non-human
    tracking

44
Next MEDSIS Project plan, 04/05
  • Refinement of interface and features based on
    feedback
  • Rollout to all county health departments
  • Outreach to all hospitals and clinical
    laboratories
  • Gathering business requirements for an outbreak
    management and a contact tracing modules
  • Begin outreach to clinics, providers, and schools

45
SIREN/MEDSIS Team
  • Team Leaders
  • Ken Komatsu
  • John Nelson
  • Epidemiology Team Members
  • Deniz Akinc
  • Jennifer Orsi
  • Technical Team Members
  • Paul Barbeau
  • Bryan Christopher
  • Tim Colman
  • Joseph Urrea
  • Partner Development
  • County Health Departments
  • GITA

46
Additional Information
  • http//www.cdc.gov/NEDSS
  • http//www.cdc.gov/PHIN
  • http//www.hl7.org
  • http//www.snomed.org/
  • http//www.loinc.org/

47
Public Health and Hospital Information Systems
  • Minimize the time to detection
  • Reduce the burden of manual reporting
  • Next steps
  • Coordinate an assessment of hospital information
    systems related to reporting and data exchange
  • Prioritize and begin discussions

48
Data Exchange
  • Secure Socket Layer (SSL)/ Transport Layer
    Security (TLS)
  • Secure Socket Shell (SSH)
  • Browse and upload

49
Questions?
  • For more information contact
  • Ken Komatsu, Surveillance Project
    Coordinator 603-364-3587 kkomatsu_at_siren.az.gov
  • John Nelson, Health Alert Network Program
    Manager 602-364-3282 jnelson_at_siren.az.gov
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