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BioSense 2.0 Current Status, Challenges and Opportunities

BioSense 2.0 Current Status, Challenges and Opportunities. CSTE Pre-Conference Workshop June 9, 2013 Kathleen Gallagher, D. Sc., MPH Director Division of Notifiable Diseases and Healthcare Information Public Health Surveillance and Informatics Program Office

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BioSense 2.0 Current Status, Challenges and Opportunities

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  1. BioSense 2.0Current Status, Challenges and Opportunities CSTE Pre-Conference Workshop June 9, 2013 Kathleen Gallagher, D. Sc., MPH Director Division of Notifiable Diseases and Healthcare Information Public Health Surveillance and Informatics Program Office Office of Surveillance, Epidemiology, and Laboratory Services Public Health Surveillance and Informatics Program Office (PHSIPO, Proposed) Office of Surveillance, Epidemiology, & Laboratory Services (OSELS)

  2. Discussion Points • Future funding and budget • Current status and activities • DUAs • Onboarding • Evaluation activities • Updating C&A • Review of new products • ICD9-ICD10 transition • Current Priorities • Challenges and Opportunities • Questions?

  3. BioSense – Cooperative Agreement Funding

  4. Timeline for Funding Year 2 of BioSense Cooperative Agreement • March 15, 2013 - RFA published • May 3, 2013 - Applications due in Grants.gov • June 14, 2013 - Funding recommendations to PGO • August 19, 2013 - NGA sent to grantees • September 1, 2013- Start date for all awards

  5. Status and Current Activities

  6. BioSense 2.0 DUA Status (June 15, 2012) • Signed DUA • New to BioSense, N=13 • Arkansas • Arizona • Illinois • Kansas • Louisiana • Montana • New Jersey • Tennessee • Virginia • Washington • West Virginia • San Diego County, CA • Washington, D.C. • Signed DUA • BioSense 1.0 and 2.0, N=4* • Indiana • North Carolina • Ohio • Tarrant County, TX DUA Under Review, N=29 Declined for this Year, N=2 • Alabama • Alaska • California • Colorado • Connecticut • Florida • Georgia • Kentucky • Massachusetts • Maine • Michigan • Minnesota • Missouri • North Dakota • Nebraska • New Hampshire • New York • Pennsylvania • Rhode Island • South Carolina • Utah • Vermont • Wisconsin • Wyoming • Boston, MA • Los Angeles County, CA • Montgomery County, MD • New York City, NY • Sacramento County, CA Engaged in Recruitment (ongoing outreach to S&L) Local Public Health *Out of 8 DUAs in BioSense 1.0. The other 3 states are anticipated to sign soon (MI, MO, GA). Cook County is participating under the IL DUA. There was no data loss from 1.0 to 2.0, as all data is captured in the CDC locker.

  7. BioSense 2.0 Signed Data Use Agreements • N=44 • Alabama • Alaska • Arizona • Arkansas • Florida • Illinois • Indiana • Kansas • Louisiana • Maine • Maryland • Michigan • Minnesota • Mississippi • Missouri • Montana • Nebraska • Nevada • New Hampshire • New Jersey • New Mexico • New York • North Carolina • Ohio • Pennsylvania • Rhode Island • Tennessee • Texas • Utah • Vermont • Virginia • Washington • West Virginia • Wisconsin • Boston, MA • Denver, CO • El Dorado Co., CA • Houston, TX • Marion Co., IN • New York City, NY • Sacramento Co., CA • San Diego, CA • Tarrant Co., TX • Washington, D.C. May 29, 2013

  8. BioSense 2.0 Data by State • N=28 • Alabama (2 of 101) • Alaska (1 of 20) • Arizona (8 of 70) • California (13 of341) • Colorado (5 of 83) • Illinois (50 of 193) • Indiana (107 of120) • Kansas (28 of 131) • Louisiana (38 of 113) • Maine (26 of 37) • Maryland (1 of 48) • Massachusetts (11 of 73) • Missouri (77 of 119) • Montana (3 of 58) • Nevada (15 of 33) • New Mexico (9 of 37) • New York (1 of 199) • North Carolina (119 of 119) • Ohio (176 of 189) • Pennsylvania (119 of 171) • Rhode Island (7 of 10) • Texas (72 of 439) • Utah (38 of 46) • Virginia (7 of 96) • Washington (19 of 95) • Washington, DC (4 of 8) • West Virginia (5 of52) • Wisconsin (46 of 126) May 29, 2013

  9. Updating C&A • Originally approved by CDC November 2011 • Needs to be updated to incorporate all changes to the BioSense 2.0 environment • Needs to comply with FedRamp requirements re: cloud environments • ( waiting for guidance on how to do this) • Current environment continues to operate as is while updated submission is being prepared and reviewed • Opportunity for incorporating other changes to the environment

  10. Process for Review of New Products, Priorities and Functions • Established weekly internal “feature” review • Requests from all stakeholders • Establish process for reviewing requests from BioSense governance (or others?) • Newly formed PHSIPO IT governance and review process • Product Review • Technical design and architecture • Data exchange and integration • Security/ Privacy • Cost/ Licensing • Functionality (analytic capacity, data coding)

  11. Current Priorities ( next 1-2 years) • Onboard ED data from all participating jurisdictions • Onboard national  lab and pharmaceutical sales data and enable these data to be shared with participating state and local PH jurisdictions • Expand sharing of data in BioSense environment between state and local health jurisdictions • Develop robust and objective process for evaluating ( and adding ) analytical and visualization products for use in the BioSense environment • Increase the utility for CDC of data from BioSense 2.0 to describe and monitor all hazards situational awareness at the national level

  12. Evaluation Activities • Evaluation with key external stakeholders (RTI) • will assess the performance, use, utility, usability, and costs of the system as well as the onboarding experience. The evaluation is intended to guide the Governance Group, CDC, state, local, and territorial (STLT) stakeholders and the RTI BioSense Redesign team in their deliberations and decisions about the development of BioSense 2.0. • CDC Internal Evaluation • to ensure the whole of the BioSense program will meet its goals and demonstrate its value to public health, an internal evaluation is warranted to explore current issues and identify key activities that will realize the program's objectives.

  13. BioSense 2.0 Challenges • Capacity ( internal and external) • Analytic ( Big data, switch from SAS to R) • Community of Practice • Coordination • Multi-dimensional project with many“ moving parts” with many intersections and interfaces • Technical, legal, policy, security, programmatic considerations • Communication • Promoting utility to cynics • Managing expectations of advocates • Onboarding Data • This is a rate-limiting step • Operationalizing the sharing of data across jurisdictions/owners

  14. BioSense 2.0 Opportunities • Expand data use to include non-infectious conditions (e.g, MI, injury) • Explore other sources of data ( weather, EMS, social media) • MUse Stage 3 for outpatient & inpatient facilities • Expand coverage and representativeness of participants • Expand Community of Practice • Including other federal partners?

  15. Thank you

  16. ASTHO and CDC Building BioSense 2.0June 2011 – June 2012 • Governance • ASTHO established an interim S&L governance structure • Meeting every other week since early winter • Establishing BioSense 2.0 Cloud • ASTHO identified Amazon Web Services as the Cloud vendor of choice • Worked with BioSense redesign team to set up cloud environment • BioSense 1.0 retired April 2012 • BioSense 2.0 Open for Business • S&L HDs can initiate or expand their syndromic surveillance systems under the MUse program for their own jurisdiction • CSTE started recruitment in coordination with ASTHO, NACCHO, CDC, and ISDS (67 jurisdictions) • Stakeholders begin collaborating among themselves and CDC in new environment governed by data use agreements established with ASTHO • CDC BioSense 2.0 Funding Opportunity proposals due June 26

  17. ASTHO and CDC Building BioSense 2.0Next steps • June 2012: Establish permanent governance structure • July 2012: Award BioSense 2.0 cooperative agreement • $7 million for up to 35 sites • December 2012: Demonstrate examples of data sharing • October 2013: 32 DUAs signed • June 2014: Redesign complete

  18. OSELS Current Priority Initiatives • Increase use of electronic health records as part of an integrated system for public health surveillance • Improve public health data access, analysis, interpretation, and communication • Develop an efficient, sustainable and integrated network of public health laboratories • Prepare the public health workforce to meet 21st Century challenges

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