Assessing Surveillance Methodology, Performance, and Design: Indicators for Public Health Surveillance

BACKGROUND:   Public Health Practice, LLC developed a conceptual model that will assist public health organizations to measure gaps in public health surveillance performance and provide a toolset to assess interventions, cost, and return on investment. METHODS:   We conducted a review of academic, open source, and grey-literature to identify public health surveillance components. The findings produced five public health surveillance logic model domains: IHR, event-based, indicator-based, syndromic, and predictive surveillance. Subtypes of surveillance are comprehensively outlined to detail the inputs, activities, and expected outcomes of each methodology. Indicators were mapped to measure these logic model elements. To statistically evaluate these indicators, we plan to utilize principle component analysis (PCA), to weight the indicators and refine them over time. The tool also graphically displays measured gap data and provides recommendations to enhance surveillance using an integrated cost-impact analysis. RESULTS:   This new conceptual framework: (1) describes the work practices to achieve effective and efficient public health surveillance, (2) identifies impediments and gaps in performance, and (3) assists program managers in decision making. This framework also provides a blueprint of several public health surveillance domains. Further, the interactive tool enables decision makers to allocate resources to prioritized needs and assesses cost versus impact. Currently, there is no model to identify and measure gaps in surveillance performance for the various public health surveillance domains. Likewise, there is no toolset to assess possible interventions by costing them and estimating the return on investment. CONCLUSIONS:   We developed an interactive and comprehensive toolset useful to domestic state and local health departments when assessing progress toward implementation of the surveillance capacities. This tool will collect measureable data to track progress toward establishing effective and efficient public health surveillance. We plan to pilot this toolset in the field and refine indicators using PCA.