KFL

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KFLA Health Unit Geospatial EDSSGeospatial
mapping of respiratory and gastrointestinal
hospital visit data through a regional,
real-time, emergency department surveillance
system for Decision Support and Community
Awareness

• Interim Report
• March 28th, 2008
• Updated June 11, 2008

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Outline

• Project overview
• Summary of Users Needs
• User Interface Mock-up Walkthrough
• Next Steps

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Introduction

• Kingston Frontenac and Lennox Addington (KFLA)
  Public Health in association with the Queens
  University Public Health Informatics (QPHI) Team
  is undertaking a project to inform health
  professionals and other members of the community
  about up-to-date utilization of local Emergency
  Departments for respiratory and gastrointestinal
  illness.
• The purpose of the project is to enable informed
  decision making in the community.
• Reporting of this data on maps showing activity
  by neighbourhood is expected to allow infection
  control practitioners, family physicians,
  community access centers, long term care
  facilities, schools and child care centers
  amongst others to know immediately current
  respiratory and gastrointestinal infectious
  activity in the community.

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Project Vision

• To reduce morbidity and mortality in the
  community from infectious illnesses by providing
  the right message to the right people in the
  right place, at the right time.

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Objectives

• 1) Limit the spread of disease
• 2) Reduce the impact on hospital emergency
  departments
• 3) Save lives among at risk populations
  (children and elderly) and,
• 4) Better understand the spread of disease.

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Project Overview Approach Timelines
Jan 14 25
Feb 6 Mar 28
Apr 2 Jun 30
Jul 11
Initiation Planning
System Analysis Design
Development
Launch Date

• Test System
• Make final modifications
• Implement external communications plan

• Kick-off Project
• Develop Project Charter
• Develop Project Plan, Resource Plan,
  Communications Plan

• Analyze RODS / EDSS System, Geospatial aspatial
  data requirements,
• Validate user needs
• Design complete system

• Develop Database, ETL, GIS and web components
• Develop system documentation
• Integrate system with RODS
• Integrate system with web sites

Activities

• Live, publicly available GDSS System (soft launch)

• System Architecture Design Document

• Project Charter Project management Plan

• GDSS System

Deliverables
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Summary of Users

• Public Health / Healthcare Professionals
• Medical Officers of Health from KFLA Public
  Health and HPECHU
• PH Nurses (CD, adult, school, dental, infectious
  diseases)
• Local physicians/nurses and hospital
  administrators
• Long Term Care Homes (LTCH) CCAC
• Home care and field professionals (OT/PT, speech
  therapists, etc.)
• Institutions / Institutional Administrators
• School board, Schools, Universities, Colleges
• Child care
• Employers
• Police Fire, all EMS
• Municipal officials
• General Public
• Local citizens
• All citizens will have real-time access to
  geospatial data informing them of respiratory and
  gastrointestinal outbreaks and linking them
  directly to further information, ongoing
  epidemiological analyses such as viral lab tests
  (eg. Influenza and RSV results) and results of
  suspected reportable gastrointestinal diseases.

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Ex.1 Public Health CD Nurses

• Important Characteristics
• Apt to use RODS/ EDSS, or reports / outputs
  generated from it
• Potential users of GDSS to assist in outbreak
  investigation
• Useful Functions would include
• Ability to interact with map of the health unit,
  with locations of institutions (hospitals, LTCs,
  schools, university colleges, penitentiaries,
  large employers, daycares etc.)
• Ability to view attributes of institutions such
  as school populations, bed censuses and key
  contacts in the map

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Ex.2 Family Physicians

• Important Characteristics
• Overwhelmed with information sources, media
  tools
• Get a feel for when something is going around
  from diagnostic trends and discussions with
  colleagues variety of other sources
• Useful Functions would include
• Ability to confirm assumptions about infection
  trends in the community with evidentiary support
• Support patient education (this is where you
  live, in a hotspot) Reinforce behaviours with
  patients (vaccinations, hand-washing)
• Provide a central resource for disease
  information, case definitions, etc. (take away
  with URL?) for patients
• Ability to zero in on hotspot areas
• Ability to quick search by postal code

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Ex.3 School Board Personnel

• Important Characteristics
• Communicate with students and families through
  newsletters, web site, phone calls from secretary
• High degree of regular interaction in meetings
  (district, principals, vice-principals)
• Useful Functions would include
• Ability to better plan for and predict HR
  shortages e.g. caused by increased teacher
  absenteeism (i.e. supply requirements)
• Ability to better inform families about
  infections affecting school population (were
  experiencing an outbreak, keep your ill child at
  home)
• Provide evidentiary criteria to changes in
  pandemic status (level 1, 2, 3, 4)
• Provide a central resource for disease
  information, fact sheets, vaccination locations
  etc., for students and families
• Provide specific information for high-risk groups
  (e.g. special needs)
• Provide links to infectious disease information
  directly on school and board websites

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Ex.4 Community Members

• Important Characteristics
• Many media sources competing for attention web
  sites are just one aspect
• Want to know when they should stay home, keep
  children home, teach prevention to family,
  learning tool
• Useful Functions would include
• Ability to subscribe to e-mail listserv to
  receive high-level advisories follow link to web
  site for maps and additional information
• Ability to become more informed about infections
  symptoms, precautionary information, fact sheets
  about GI respiratory infections, recovery
  periods, etc.

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Ex.5 LTCH Infection Control

• Important Characteristics
• Receives outbreak info from multitude of sources
  reports from 3 local HUs, LTCHs, RODS output from
  Tara _at_ KFLA, Flu Watch, local news, ProMed
• Information received is not nearly as quick as
  one would like
• Maintains list of ongoing outbreaks and
  distributes to LTCH admitting teams, ICPs,
  medical records tool can provide a heads up)
  to those that receive the reports and others in
  out in the field (OT/PT etc.)
• Useful Functions would include
• Ability to incorporate data from additional
  sources beyond ED, including all schools, (esp.
  primary), universities and colleges, inside LTCH,
  family doctor visits, TeleHealth

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Next steps

• Project / Development
• Complete Review of System Design Specifications
• Begin System Development
• Refine UI Characteristics
• Initiate Integration Planning with KFLA website
• Communications
• Engaged HCNSEO (facilitated by Dr. Gemmill)
• Full roll-out planned for October (start of flu
  season)
• City wide communication plan (radio, tv,
  newspaper, press conference?)