the sidartha surveillance approach kingston, canada june 13, 2008
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The SIDARTHa surveillance approach
Kingston, Canada
June 13, 2008
The European Emergency Data GroupResearch Network
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
EED Group - Research NetworkActivities
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)
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.: Comparison of effectiveness and efficiency of the EMS systems in Birmingham (UK) and Bonn (D). In: Anästhesiologie, Intensivmedizin, Notfallmedizin Schmerztherapie 38: 630-642. (German)
2004: Fischer, M. et al.: Comparison of effectiveness and efficiency of the 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 to the European Emergency Data Project: EMS Data-based Health Surveillance System (SPC.2002299). Geomed Research Group. Köln.
1996: Krafft, T. and L. García Castrillo-Riesgo (ed.): Professionalisation or Marketisation in Health Care – EMS in Transformation. Bonner Geographische Abhandlungen 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.
EED Group - Research NetworkOutput
SIDARTHaThe European Project
General Objectives
to contribute to and to enhance the generic preparedness of the health sector for 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.
EvaluationImplemen-
tation
Information
Possibilities
Needs
PHASE I - Conceptualisation PHASE II - Implementation
Project Coordination
Dissemination of Project Results
Project Evaluation
Project Overview
Administrative Project Structure
PHASE I - Conceptualisation PHASE II - Implementation
WP 7Pilot Phase
WP 2 - Dissemination of Project Results
WP 3 - Project Evaluation
WP 1 - Project Coordination
Workshop + Steering Committee Meeting
Steering Committee Meeting only
WP 4 Best
practice - local
practice
WP 5 EM data-
based surveillance
WP 6Design &
Callibration
Work PackageWP
M Month of project time
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
Specific Objectives
Project Group
Prof. Dr. Luis Garcia-Castrillo Riesgo (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)emergency medicine, national health authority representative, medical director of regional EMS
Ing. Gernot Vergeiner (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. Enrico Davoli - 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) & ECDCto be nominated by institutions
State Dispatch Centre Tyrol, Innsbruck/Austria Gernot Vergeiner
Federal Government, Department of Public Health, Organisation of Care Institutions, Brussels/Belgium
Agnes Meulemans
Emergency Medical Service Prague/Czech RepublicMilana Pokorna
Capital Region of Denmark, Devision of Planning and Development, Copenhagen/Denmark
Freddy Lippert
University Hospital, Department of Anaesthesiology and Intensive Care, Kuopio/Finland
Jouni Kurola
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/HungaryGabor Göbl
San Martino University Hospital, Genoa/ItalyFrancesco Bermano
Haukeland University Hospital, Bergen/NorwayGuttorm Brattebo
University of Cantabria, Santander/SpainLuis Castrillo
University Hospital, Antalya/TurkeyHakan Yaman
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 European Health Surveillance Complex
EU surveillance concept
European Health Emergency Network - Actors
European Commission’s
Directorate General Health and Consumers
European Commission’s Health
Threat Unit (HTU)
European Centre for Disease Prevention and
Control
World Health Organization Regional
Office for Europe
27 EU Member StatesHealth Ministries
Other European Commission’s
Directorates General
Health Emergency Operations Facility
(HEOF)
Emergency Operations
Centre
European Health Surveillance / Alert Network
European Commission’s
Directorate General Health and Consumers
European Centre for Disease Prevention and
Control
World Health Organization Regional
Office for Europe
27 EU Member StatesHealth Ministries
Other European Commission’s
Directorates General
Dedicated Surveillance Networks / TESSyOther Alert Systems
EWRS/Rapid Alert Systems
MedISys
National Surveillance Systems
CISID / GOARN
DSN – Dedicated Surveillance 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
EWRS – Early Warning and Response System
MedISys – Medical Intelligence System
SIDARTHa The Anticipated Surveillance System
Intended System Design
Local Health Surveillance
System
Hospital
A
EMS A
Hospital
B
EMS B
Local Health Authority
National Health
Authority
EWRS
MedISys
DSN/ RAS
Emergency Professionals
Risk Communication Platform
European Health Surveillance System
Communication/Support
Alert
Automatic Data Transfer
Website
Automatic Data Processing/ Analysis
Local Health Surveillance
System
Local Health Surveillance
System
Local Health Surveillance
System
Rapid Alert Systems, e.g., RAS-CHEM (chemical emergency)
Dedicated Surveillance Network (disease specific)
Medical Intelligence System
Early Warning & Response System
RAS
DSN
MedISys
EWRS
Intended System Design – Local Level
EMS A
Local Health Surveillance System
Automatic Data Cleansing
Automatic Syndrome Generation
Automatic Comparison with Threshold
Automatic Historical Data Analysis
Emergency Professionals
Risk Communication Platform
European Health Surveillance System
GIS-based Automatic Generation of Spatial-Temporal Thresholds
Local Health Authority
European Health Surveillance System
Local Health Surveillance
System
Local Health Surveillance
System
Local Health Surveillance
System
A B C D
6 9 7 3
9 2 8 4
Local Report /
Alert
National Report /
Alert
European Report /
Alert
GIS-based Analysis Tool
Emergency Professionals
Risk Communication Platform
Intended System Design – European Level
SIDARTHa – System‘s Strengths
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
Thank you!