Best Practices for Implementing a Syndromic Surveillance System Across Jurisdictions

Key Objectives:
In this roundtable, we will provide some example strategies we have employed in Oregon for rolling out a state-housed, locally-shared syndromic surveillance system and will engage the audience in broad questions of sustainability for this data system. The intensive technical requirements for syndromic Meaningful Use syndromic streams often result in one Public Health Authority acting as the data repository for others; we believe discussions of surveillance autonomy and sustainability in Oregon may broadly apply to other jurisdictions involved in either housing or using syndromic data across jurisdictions.

Brief Summary:
The Meaningful Use payment program has incentivized the exchange of syndromic surveillance data from health systems to Public Health Authorities. Because of the technical requirements of Meaningful Use, significant informatics resources must be devoted to syndromic data processing, often resulting in one jurisdiction housing data for others. This is the case in Oregon, where the state Public Health Division houses the syndromic surveillance project for local health departments, including the Multnomah County Health Department. When the surveillance system is housed in one jurisdiction, but intended for use by many others, we seek to understand best practices in collaborative surveillance across jurisdictions. In this roundtable, we will discuss best practices for cross-jurisdiction data storage, access and practitioner engagement for novel syndromic surveillance systems. We plan on discussing how the roll-out of syndromic surveillance can best support the business case of surveillance in each jurisdiction, how data are best shared between regions, key rationales for supporting this system at the local and state levels and strategies for identifying syndromic advocates among participating jurisdictions and health systems. We will share our experiences (local and state) with these questions using case-based scenarios (e.g., boil water advisory, Enterovirus D68 and overdose surveillance). This dialog contributes to the national conversation of syndromic surveillance, particularly as it relates to the investment in Meaningful Use data among jurisdictions new to this data stream, including jurisdictions supported by the Centers for Disease Control and Prevention BioSense program. Where both technical and epidemiological capacities support the roll-out of syndromic surveillance, the questions of access and the business case of syndromic surveillance are major hurdles for adoption of these tools. Collaborative work and collection of best cross-jurisdictional practices to achieve sustainable, productive information systems remain primary objectives as we seek to quantify the value of these massive public health investments.