1. Epi Gateway: A one-stop surveillance shop
Christie Luce
2008 PHIN Conference

2. Epi Gateway Background
Was part of EpiCom – the department’s outbreak communications and emergency notification system
External facing application
(web board + alerting + other sub-applications)
2007 – EpiCom becomes part of the Florida Department of Health Emergency Notification System (FDENS)
Sub-applications are left behind
2008 – Epi Gateway is developed and formalized

3. (External facing site)
CHD influenza activity code reporting
Pneumonia and influenza mortality reporting
EpiCom
(External facing site)
Electronic case reporting
Respiratory laboratory test reporting

4. Organizational Structure
Division of Disease Control
A.G. Holley TB Hospital
Bureau of Epidemiology
Bureau of Sexually Transmitted Diseases
Bureau of HIV/AIDS
Bureau of TB & Refugee Health
Bureau of Immunizations
Merlin
PRISM
HARS
TIMS
SHOTS

5. Background Each bureau maintains its own surveillance system
Former “silo” mentality, but slowly coming together
Front line county health department staff (epidemiologists & public health nurses) usually have job duties that span the program areas
Must continually switch between applications – remembering user name and password for each

6. Purpose & Goals To bring together all department surveillance systems
County health department staff wear a variety of hats
To make the transition between systems appear seamless
Using single-sign-on (SSO) capabilities
To expand electronic reporting capabilities to external partners (practitioners)
To link the users that are submitting data with the data
Users can generate reports and graphs

7. SUB APPLICATION County Flu Activity –
Counties report flu activity in their areas; similar to state assigned code as reported weekly to CDC
Respiratory epidemiologist develops a state activity code
State code is sent to CDC
Internal application – all users are DOH county staff

8. SUB APPLICATION: COUNTY FLU ACTIVITY

9. SUB APPLICATION Pneumonia & Influenza Mortality Reporting
Vital Statistics staff scan death certificates and enter the number of people (by age) whose death was attributable to pneumonia and/or influenza
Reports and graphs are viewable by county health department staff and Bureau of Epidemiology staff
Internal application – all users are DOH county staff

10. SUB APPLICATION: PNEUMONIA & INFLUENZA MORTALITY

11. SUB APPLICATION: PNEUMONIA & INFLUENZA MORTALITY

12. SUB APPLICATION: PNEUMONIA & INFLUENZA MORTALITY

13. SUB APPLICATION: Respiratory Laboratory Test Result Reporting
Modeled after NREVSS
Includes capacity to submit for all or any of the following: RSV, influenza, parainfluenza and adenoviruses
Hospitals enter the number of tests performed and number of positive results each week
Reports are viewable by hospital staff, county health department staff, and Bureau of Epidemiology staff
Chance to partner with Children’s Medical Services
Internal and external application – end users are hospital staff and DOH staff

14. RESPIRATORY SYNCYTIAL VIRUS

15. SUB APPLICATION Electronic Case Reporting
Infection Control Practitioners from participating hospitals can enter a case electronically
Information being transmitted is confidential and must be protected
Information is sent via secure socket layer (SSL) and is pulled into the Merlin reportable disease surveillance application via a web service call
Hospitals have access to the information they have submitted for audit purposes
External application – end users are hospital staff

17. Epi Gateway Architecture Ad hoc Surveillance Sub Applications
Integration
Program Area Surveillance Systems
Other Surveillance Systems
Interface
Epi Gateway

18. Integration & Interface become transparent by using:
Architecture
Integration & Interface become transparent by using:
Single Sign On
Similar look and feel
Users experience: Minimally impacted when switching from one application to another

19. System Security Written primarily in .net environment
Utilizes a SQL database
Database is located separate from web server and sits behind the DOH firewall
Entire application is scanned before Change Control will allow code to be altered in the production system
Uses a template for each DOH application
Must mitigate vulnerabilities or accept risk

20. Future Considerations
Establish links to:
Other surveillance systems
Environmental health systems
Syndromic surveillance systems
Other valuable resources
NEDSS-AVR, Data Warehouse
Provide tools for:
Electronic Laboratory Reporting
Small labs can report a single case electronically
Established precedent for bring confidential information from an outside source into the DOH network

21. Next Steps
Evaluate effectiveness
Plan and execute expansion

22. Contact Information
Christie Luce Florida Department of Health Bureau of Epidemiology ext 2450