Igotsick: Evaluating a Centralized, Online, Self-Reported Foodborne Illness Complaint System

BACKGROUND:   Using the CDC Framework for Program Evaluation as a guide, the Utah Department of Health (UDOH) evaluated Utah’s centralized, online, self-reported foodborne illness complaint system (“igotsick”).   The objectives of igotsick are to: 1)     Streamline and encourage data sharing and communication between state and local epidemiology and environmental health partners. 2)     Capture quality foodborne illness data in a timely, cost-effective way. 3)     Capture data from ill persons without a laboratory-confirmed diagnosis. 4)     Detect outbreaks and other concerns to drive public health response.

METHODS: Primary evaluation questions:

• How has the complaint system been utilized?
• How can the complaint system be improved?
• To what extent has the complaint system detected foodborne illness outbreaks?
• What value does the complaint system have beyond outbreak detection?

Data sources:

• Online complaint data and Google Analytics statistics (2/1/13 – 1/31/15)
• Interviews with epidemiology and environmental health partners
• Survey of Utah citizens
• Telephone complaint data
• Utah public health outbreak tracking data

RESULTS: Data collection and analysis are still underway at this writing. Preliminary results are shared here.

• “Igotsick” captures foodborne illness data directly from the public promptly and at minimal cost. 
• The system is used  by a range of age groups and provides data which is not captured via traditional surveillance systems.
• Constant monitoring of complaints ensures prompt public health action, including environmental health inspections and epidemiology investigations.
• The system is valued by epidemiology and environmental health partners, and has improved data sharing and communication.
• Relatively few complaints are received (an average of 26 per month, or 10.4 per 100,000 population per year). Complaints have not increased substantially over time.
• At this writing, 596 complaints have been received and two outbreaks detected. This is a rate of 3.4 outbreaks detected per 1,000 complaints, well below the lowest target level specified by CIFOR * (acceptable: 10-20 outbreaks/1,000 complaints; preferable: >20). 

Further analysis will provide detailed information on system use, factors limiting the number of complaints, data quality of specific data fields, and barriers to outbreak detection. * Council to Improve Foodborne Outbreak Response (CIFOR). Guidelines for Foodborne Disease Outbreak Response. Atlanta: Council of State and Territorial Epidemiologists, 2009.

CONCLUSIONS: While successful in other ways, the complaint system has yet to succeed in outbreak detection. Increased publicity, system improvements, or both may be needed to increase its value to public health.