What to Consider When Using BioSense 2.0 Bill Stephens NACCHO Advanced Practice Center Tarrant County Public Health TX

Overview Identify your experience Consider important questions Focus on the setup model Good communication Identify roles Resources

Identify Your Experience Sites new to Syndromic Surveillance Sites with Syndromic experience More than we can go over today in detail, but NACCHO has a self assessment survey to help start asking the right questions and begin planning: http://naccho.us.qualtrics.com/SE/?SID=SV_8oAIIfcuxjsgNJq

New Sites Consider: Why you are using BioSense 2.0 Workforce/personnel required State and local roles (not system based security roles, but main responsibilities) Hospital agreements and ASTHO agreement Data flow (Hosp to HD to Cloud, Hosp to Cloud, Permutations within cloud (i.e. BioSense, ESSENCE, etc.)) Permissions and system based security roles

Experienced Sites Revisit: Consider: Why using BioSense Workforce/personnel State and local roles (not security roles, but main responsibilities) Hospital agreements Data flow (Hosp to HD to Cloud, Hosp to Cloud, Permutations within cloud (i.e. BioSense, ESSENCE, etc.)) Permissions and system roles Consider: Business process redesign Take into account: maintaining multiple systems (i.e. defining the purpose of each) End user retraining Partner education/communications about changes

Model Setup Have to Consider: Options: Technical AND Business or Practice issues Options: Centralize Regionalize Localize

Technical Model Considerations Does the LHD have technical personnel to manage data feeds? Does the Region have technical personnel to manage data feeds? Does the State have technical personnel to manage data feeds? Don’t forget about CDC technical resources

Tarrant County Results Key Lessons Learned Establishing connectivity is easy, utilizing hardware VPN routers and MIRTH data integration solutions for LHDs and hospitals. Establishing proper locker configuration based on actual jurisdictional authority needs clear specification in the earliest phases where state may not be the sole access controlling authority Data validation compared to local or regional baseline system or analytical verification tools expedites BioSense 2.0 validation process Segmentation of user groups into two broad categories essential for use-case development and training- new or experienced users. As usual, one size BioSense implementation does not fit all.

Tarrant County Technical Model Best Practices Obviously not every State, Regional, and Local environment will fit. But we’ve found success: Regional model supported by local context Enhance local capacity State plays more of a supporting and encouraging role and coordinating regions to be effective network across the state very important and nice for a state the size of TX – would be difficult for state staff to support whole state

Business/Practice Model Considerations “Natural Cooperation” based on daily existing relationships with hospital staff (i.e. IPs) Data quality – Context counts and locals have it Anomaly (DQ or event) detection requires good communication and interoperability with partners – often best through local relationships Response protocols – Essential to buy-in from staff and partners and must be locally focused

Resources Tarrant County Biosurveillance Compendium: Training and exercise materials Community building materials: Federal partners First Responders Medical Community Schools HIPAA guidance How to implement Syndromic Surveillance Literature Response Protocols CDC Technical Support ASTHO staff convene governance over shared resources in the cloud NACCHO and CSTE staff can foster peer to peer assistance, create best practice documentation, and foster regional communities of practice ISDS provides the Syndromic Surveillance Community of Practice, research and innovation, Meaningful Use guidance, and a NACCHO sponsored Syndromic 101 course

Final Thoughts Re-enforce hybrid model – Region and local focused surveillance that meets minimal standards that enhance the sharing across jurisdictions Overall fits way HIT is evolving – i.e. regional HIEs that are stitched together across the state and all talking over interoperability standards Next steps of the pilot is to work with key informants Developing use cases specific to the new BioSense platform – how do we get this new tool into routine Epidemiology and practice? Translating between state perspective and local perspective Coordinating interventions Provide value for hospitals and providers For those who want more details, Our partners at ASTHO and RTI will be hosting webinars on “Transport” and “Security” for BioSense 2.0 – look for those in the next two weeks

Questions? Bill Stephens Tarrant County Public Health Advanced Practice Center (817) 321-4730 wfstephens@tarrantcountytx.gov For more resources, go to apc.naccho.org