The SIDARTHa surveillance approach
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The sidartha surveillance approach kingston canada june 13 2008

The SIDARTHa surveillance approach

Kingston, Canada

June 13, 2008


The sidartha surveillance approach kingston canada june 13 2008

The European Emergency Data Group

Research Network


The sidartha surveillance approach kingston canada june 13 2008

European Emergency Data (EED) Group

Research Network

  • Loosely formed research network of European health researchers, clinicians, emergency physicians, EMS professionals and health authority officials

  • Aim: comparing EMS systems internationally, defining best practice and standard procedures, developing monitoring and surveillance concepts based on EMS data

  • since 1996

  • partners in 19 European countries and one partner in the USA


The sidartha surveillance approach kingston canada june 13 2008

EED Group - Research Network

Activities

  • 1996-2000: EED I & II - Comparing EMS in Birmingham (UK), Bonn (D) & Santander (ES)

  • 2002-2006: EED III - European Emergency Data-based Health Monitoring System (co-funded by European Commission)

  • 2004-2007: Involvement in EU Injury Data Base Development (Phase II) (co-funded by European Commission)

  • 2004-2008: Utstein Standard for European Emergency Medical Dispatch (co-funded by Leardal Foundation)

  • 2007-2010: SIDARTHa - European Emergency Data-based Syndromic Surveillance System (co-funded by European Commission)


The sidartha surveillance approach kingston canada june 13 2008

EED Group - Research Network

Output

  • 1996: Krafft, T. and L. García Castrillo-Riesgo (ed.): Professionalisation or Marketisation in Health Care – EMS in Transformation. Bonner GeographischeAbhandlungen 95. Dümmler. Bonn. (English/German)

  • 2000:Krafft, T. et al. : European Emergency Data (EED) Project. Comparing European EMS Systems. Working Report II: Scope, Aims, Findings. Keese. Bonn.

  • 2003: Krafft, T. et al.: European Emergency Data Project (EED Project). EMS Data-based Health Surveillance System. In: European Journal of Public Health 13(3,Suppl): 85-90.

  • 2003: Fischer, M. et al.: Comparisonofeffectivenessandefficiencyofthe EMS systems in Birmingham (UK) and Bonn (D). In: Anästhesiologie, Intensivmedizin, Notfallmedizin Schmerztherapie 38: 630-642. (German)

  • 2004: Fischer, M. et al.: Comparisonofeffectivenessandefficiencyofthe EMS systems in Birmingham (UK) and Bonn (D). In: Der Notarzt 20: 51-63. Reprint. (German)

  • 2006:Krafft, T. et al.: Health Monitoring & Benchmarking of European EMS Systems: Components, Indicators, Recommendations. Project Report tothe European Emergency Data Project: EMS Data-basedHealthSurveillance System (SPC.2002299). Geomed Research Group. Köln.


The sidartha surveillance approach kingston canada june 13 2008

SIDARTHa

The European Project


The sidartha surveillance approach kingston canada june 13 2008

General Objectives

  • to contribute to and to enhance the generic preparedness of the health sectorfor communicable as well as non-communicable health threats and emergencies

  • improvement of timeliness and cost-effectiveness of European and national surveillance providing a basis for systematic syndromic surveillance by

  • establishing a system that automatically will transfer, process and analyse near real-time emergency data and automatically provide spatial-temporal surveillance reports and alerts.


The sidartha surveillance approach kingston canada june 13 2008

Project Overview

PHASE I - Conceptualisation

PHASE II - Implementation

Information

Possibilities

Evaluation

Implemen-tation

Needs

Project Coordination

Dissemination of Project Results

Project Evaluation


The sidartha surveillance approach kingston canada june 13 2008

Administrative Project Structure

WP 1 - Project Coordination

WP 2 - Dissemination of Project Results

WP 3 - Project Evaluation

PHASE I - Conceptualisation

PHASE II - Implementation

WP 4

Best practice - local practice

WP 7

Pilot Phase

WP 5

EM data-based surveillance

WP 6

Design & Callibration

Workshop + Steering Committee Meeting

Steering Committee Meeting only

WP

Work Package

M

Month of project time


The sidartha surveillance approach kingston canada june 13 2008

SpecificObjectives

1. Assessment of best and local practice of emergency data-based surveillance

2. Identification of health threats & definition of surveillance indicators

3. Identification of average demand patterns & thresholds for spatial-temporal clustering

4. Specification of user needs by experts from the relevant health sector target groups

5. Definition of algorithms of the system & specification of system design

6. Set-up of SIDARTHa

7. Test & evaluation of SIDARTHa’s performance & recommendations for future use


The sidartha surveillance approach kingston canada june 13 2008

Project Group

  • State Dispatch Centre Tyrol, Innsbruck/Austria GernotVergeiner

  • Federal Government, Department of Public Health, Organisation of Care Institutions, Brussels/Belgium

  • Agnes Meulemans

  • Emergency Medical Service Prague/Czech Republic

  • MilanaPokorna

  • Capital Region of Denmark, Devision of Planning and Development, Copenhagen/Denmark

  • Freddy Lippert

  • University Hospital, Department of Anaesthesiology and Intensive Care, Kuopio/Finland

  • JouniKurola

  • Emergency Medical Service for Province Hauts de Seine, Garches/France

  • Michel Baer

  • Hospitals of County of Goeppingen, Goeppingen/Germany Matthias Fischer

  • National Emergency Medical Service, Budapest/Hungary

  • Gabor Göbl

  • San Martino University Hospital, Genoa/Italy

  • Francesco Bermano

  • Haukeland University Hospital, Bergen/Norway

  • Guttorm Brattebo

  • University of Cantabria, Santander/Spain

  • Luis Castrillo

  • University Hospital, Antalya/Turkey

  • HakanYaman

  • Prof. Dr. Luis Garcia-CastrilloRiesgo (Spain)

  • emergency medicine, leader of a district EMS, emergency data analysis

  • Dr. Thomas Krafft (Germany)

  • health geography, experience in leading an EMS system, emergency data analysis, GIS/spatial-temporal analyses, EED Project leader

  • Prof. Dr. Freddy Lippert (Denmark)

  • emergencymedicine, national healthauthorityrepresentative, medicaldirectorof regional EMS

  • Ing. GernotVergeiner (Austria)

  •  EMS dispatch, leader of a high-performance state dispatch centre, emergency data analysis

  • Prof. Dr. Matthias Fischer (Germany)

  •  Emergency medicine, emergency data analysis, organiser of a state emergency medicine registry

  • Prof. Dr. Alexander Krämer (Germany)

  •  Public health, epidemiology/biometry, internal medicine, health surveillance

  • Universitad de Cantabria (Spain) – Financial issues

  • Geomed Research GmbH (Germany) – Technical issues

  • Prof. Dr. Helmut Brand – Professor for European Public Health, Head of Department of International Health, Faculty of Health, Medicine & Life Sciences, University of Maastricht, Netherlands

  • Dr. EnricoDavoli- Programme Manager, World Health Organization Regional Office for Europe, Department for Emergency Medical Services, Barcolona/Spain

  • Prof. Dr. Javier Llorca- Professor for Public Health and Epidemiology, University of Cantabria, Santander/Spain

  • Jerry Overton, MA - Director, Richmond Ambulance Authority, USA; first site in the USA that implemented the emergency data-based surveillance system First Watch™ in 2002

  • Dr. Santiago Rodriguez - Director, Health Service of District of Cantabria, Santander/Spain

  • Prof. Dr. Mark Rosenberg - Professor of Geography & Professor of Community Health and Epidemiology, Queen’s University, Kingston/Canada

  • N.N. - DG SANCO (Health Threat Unit) & ECDC

  • to be nominated by institutions

  • 2 – GEOMED - DE – Methodology of data processing, analysis, reporting

  • Subcontracting partners – Technical programming of data transfer, processing, analysis, reporting

    • SATYAM Computer Services, Inc. Hyderabad/India


The sidartha surveillance approach kingston canada june 13 2008

The European Health Surveillance

Complex


The sidartha surveillance approach kingston canada june 13 2008

EU surveillanceconcept


The sidartha surveillance approach kingston canada june 13 2008

European Health Emergency Network - Actors

European Commission’s Directorate General Health and Consumers

Other European Commission’s Directorates General

European Centre for Disease Prevention and Control

European Commission’s Health Threat Unit (HTU)

Emergency

Operations

Centre

Health Emergency Operations Facility (HEOF)

World Health Organization Regional Office for Europe

27 EU Member States

Health Ministries


The sidartha surveillance approach kingston canada june 13 2008

European HealthSurveillance / Alert Network

European Commission’s Directorate General Health and Consumers

Other European Commission’s Directorates General

European Centre for Disease Prevention and Control

Other Alert Systems

Dedicated Surveillance Networks / TESSy

EWRS/Rapid Alert Systems

MedISys

World Health Organization Regional Office for Europe

27 EU Member States

Health Ministries

National Surveillance Systems

CISID / GOARN


The sidartha surveillance approach kingston canada june 13 2008

DSN – DedicatedSurveillance Networks

  • BSN = Basic Surveillance Network

  • DIPNET = The Diphtheria Surveillance Network

  • DIVINE = Prevention of emerging (food-borne) enteric viral infections

  • EARSS = European Antimicrobial Resistance Surveillance System

  • EISS =The European Influenza Surveillance Scheme

  • ENIVD = European Network for Diagnostics of “Imported” Viral Diseases

  • Enter-net = Dedicated surveillance network for enteric pathogens

  • ESAC = European Surveillance of Antimicrobial Consumption

  • ESSTI = European Surveillance of Sexually Transmitted Infections

  • EUCAST = European Committee on Antimicrobial Susceptibility Testing

  • EU-IBIS = Invasive Bacterial Infections Surveillance in the European Union

  • EuroCJD = European Creutzfeldt Jakob Disease Surveillance

  • EuroHIV = European Centre for the Epidemiological Monitoring of AIDS

  • EuroTB = Surveillance of Tuberculosis in Europe

  • EUVACNET = A Surveillance Community Network for Vaccine Preventable Diseases

  • EWGLINET = European Surveillance of travel associated legionnaires’ disease

  • IPSE = Improving Patient Safety in Europe


The sidartha surveillance approach kingston canada june 13 2008

EWRS – Early Warningand Response System


The sidartha surveillance approach kingston canada june 13 2008

MedISys – Medical Intelligence System


The sidartha surveillance approach kingston canada june 13 2008

SIDARTHa

The Anticipated Surveillance System


The sidartha surveillance approach kingston canada june 13 2008

Intended System Design

MedISys

Emergency Professionals

Risk Communication Platform

European Health Surveillance System

EWRS

Automatic Data Processing/ Analysis

Website

DSN/

RAS

Automatic Data Transfer

LocalHealth

Surveillance

System

LocalHealth

Surveillance

System

LocalHealth

Surveillance

System

LocalHealth

Surveillance

System

Alert

Communication/Support

National Health Authority

DSN

Dedicated Surveillance Network (disease specific)

Hospital A

EMS A

Hospital B

EMS B

EWRS

Early Warning & Response System

LocalHealth Authority

MedISys

Medical Intelligence System

RAS

Rapid Alert Systems, e.g., RAS-CHEM (chemical emergency)


The sidartha surveillance approach kingston canada june 13 2008

Intended System Design – Local Level

Emergency Professionals

Risk Communication Platform

European Health Surveillance System

LocalHealthSurveillance System

Automatic Comparison with Threshold

GIS-based Automatic Generation of Spatial-Temporal Thresholds

Automatic Syndrome Generation

Automatic Historical Data Analysis

Automatic Data Cleansing

LocalHealth Authority

EMS A


The sidartha surveillance approach kingston canada june 13 2008

Intended System Design – European Level

Emergency Professionals

Risk Communication Platform

European HealthSurveillance System

European Report / Alert

National Report / Alert

GIS-based Analysis Tool

Local Report / Alert

LocalHealth

Surveillance

System

LocalHealth

Surveillance

System

LocalHealth

Surveillance

System


The sidartha surveillance approach kingston canada june 13 2008

SIDARTHa – System‘sStrengths

  • Local surveillance unit based at single institution

    • Aggregation level low: takes local specificities into account

    • Reduces data volume

    • Reduces trouble with privacy/data protection (no raw data leaves the institution)

    • Increases acceptance and distribution

  • European surveillance unit

    • Enabling cross-border surveillance (local-regional-national-EU levels)

    • Risk communication for emergency professionals between institutions

  • Real-time routine data transfer

    • No batch transfer, but real-time transfer right after incidence

    • No manual data input, no additional staff time


The sidartha surveillance approach kingston canada june 13 2008

Thank you!


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