1. Region IX Data Sharing Workgroup
Jessica White, DrPH, MS
Public Health Scientist, Office of Epidemiology

2. County of San Diego Health and Human Services Agency (CA)
Nevada County Public Health Department (CA)
Nevada Division of Public and Behavioral Health
Southern Nevada Health District (NV)
Arizona Department of Health Services
Maricopa County Department of Public Health (AZ)
Pinal County Public Health Department (AZ)
New Mexico Department of Health

3. Meeting organized by ISDS in Phoenix, AZ
Established: August 2016
Meeting organized by ISDS in Phoenix, AZ
Purpose:
To promote regional public health data sharing and collaboration by enhancing participant competency in syndromic surveillance, knowledge of partner practices, and develop plans to advance regional data sharing and cooperation
Facilitated by Charlie Ishikawa

4. Original goals 1. Data and information sharing
2. Shared use case for syndromic surveillance
Opioid syndromic surveillance
Multiple SyS systems in use
BioSense 2.0 & analysis with SAS program
Heroin – acute and chronic
Any opioid – acute and chronic
Goal: replicate tables across jurisdictions

5. Opioid Syndromic Surveillance
ISDS Annual Meeting 2016
Many jurisdictions and other Regional groups working on opioid SyS
CDC and grantees developed CC and DD Categories:
CDC Heroin Overdose v1 - v3
CDC Opioid Overdose v1
ISDS – Opioid Surveillance Committee

6. heroin diagnosis code OR (heroin term AND overdose term)
CDC Heroin Overdose V1; Maricopa County, AZ; 01Jan Apr2017; N = 429 N %
Diagnosis Codes
229
53.4%
T40.1X1A (Poisoning by heroin, accidental (unintentional), initial encounter)
175
40.8%
T40.1X4A (Poisoning by heroin, undetermined, initial encounter) 23
5.4%
T401X1A (Poisoning by heroin, accidental (unintentional), initial encounter) 39
9.1%
T401X4A (Poisoning by heroin, undetermined, initial encounter) 1
0.2%
Heroin Chief Complaint Terms
326
76.0%
DOPE 2
0.5%
HER[IO][OI]N
HERIIN
0.0%
HERION 31
7.2%
HEROIN
296
69.0%
HEROON
SPEED BALL
SPEEDBALL
SPHEROIN
Overdose Chief Complaint Terms
343
80.0%
[AO]VERDOSE
AVERDOSE
OVERDOSE
228
53.2%
ADV EFFECT DRUG
ADVERSE DRUG
ADVERSE EFFECT DRUG
ADVERSE REACTION
ADVERSE RXN
DRUG REACTION
HOD
IN[GJ]EST*
INGEST 11
2.6%
INJEST
INTOXIC* 6
1.4%
NALOXO*
NARCAN*
139
32.4%
NOD
NODDING
OVER DOSE 4
0.9%
OVEROSE
POISON* 5
1.2%
SNORT
SOBREDOSIS
Acute Heroin - Region IX Query; Maricopa County, AZ; 01Jan Apr2017; N = 449 N %
Diagnosis Codes: Heroin overdose
229
51.0%
T40.1X1A (Poisoning by heroin, accidental (unintentional), initial encounter)
176
39.2%
T40.1X4A (Poisoning by heroin, undetermined, initial encounter) 23
5.1%
T401X1A (Poisoning by heroin, accidental (unintentional), initial encounter) 39
8.7%
T401X4A (Poisoning by heroin, undetermined, initial encounter) 1
0.2%
E850.0 (Accidental poisoning by heroin; ICD-9-CM)
0.0%
E8500 (Accidental poisoning by heroin; ICD-9-CM)
Diagnosis Codes: All heroin Not listed above (Shown on next slide) 10
2.2%
T40.1 (Poisoning by and adverse effect of heroin)
199
44.3%
T401 (Poisoning by and adverse effect of heroin) 41
9.1%
Heroin Chief Complaint Terms
342
76.2%
DOPE 2
0.5%
HERION 30
6.7%
HEROIN
312
69.5%
SPEED BALL
SPEEDBALL
Overdose Chief Complaint Terms
363
80.9%
AVERDOSE
IN[GJ]EST*
INGEST 6
1.3%
INJEST
INTOXIC*
NALOXO*
NARCAN*
150
33.4%
OVER DOSE 4
0.9%
OPERDOSE
OVERDOSE
247
55.0%
POIS 3
0.7
SNORT 7
1.6%
SOBREDOSIS
TOOK MEDS
TOOK PILL
Heroin overdose =
heroin diagnosis code OR
(heroin term AND overdose term)
Heroin overdose =
heroin overdose code OR
((any heroin diagnosis code OR heroin term) AND overdose term)

7. Current activities Conference calls – bi-monthly, 3rd Wednesday
Next call: Wednesday, December 20, 12:00 MST
Community of Practice at a regional scale
Region IX workgroup includes representatives from:
ISDS CoP Steering Committee (chair)
BioSense Governance Group
ISDS Syndrome Definition Committee (chair)
Information sharing at a local scale

8. Most recent activities
Natural disasters
Wildfires in California
Human-caused disasters
Nevada (Clark County)
^gun ^,or,^gunshot^ compared to Firearm sub-syndrome
Enhanced surveillance for mass gatherings
Music festivals, sporting events, political events

9. Goals for the future
Develop action steps for advancing inter- jurisdictional data sharing and regional protocols

10. Challenges
The chapter was not launched with full representation across Region IX
It has been difficult to bring in additional jurisdictions after the fact
Shifting goals for opioid syndromic surveillance as a use case
We have not solidified a method for actual data sharing across jurisdictional lines

11. Success
Being a member of Region IX chapter has fostered collaboration and improved relationships between the peer network of syndromic surveillance professionals in the region
Examine and share best practices in analytical methods
Greatest success: Unified voice from the region  great need for opioid syndromic surveillance

12. www.healthsurveillance.org Group site – restricted access for members
Anyone from AZ, CA, HI, NV, NM, and Region IX territories may request to join