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StrengÅ·²©ÓéÀÖning Å·²©ÓéÀÖ CDC’s public health surveillance system

Modernizing BioSense, Å·²©ÓéÀÖ CDC’s cloud-based syndromic surveillance platform, improves U.S. emergency preparedness.
Results at a glance
5,800
facilities reporting
75%
of U.S. EDs participate

ICF re-architected BioSense, Å·²©ÓéÀÖ CDC’s cloud-based digital platform at Å·²©ÓéÀÖ epicenter of  (NSSP) operations. Part of Å·²©ÓéÀÖ national emergency preparedness system, BioSense increases Å·²©ÓéÀÖ ability of local, state, and national health officials to monitor and respond to Å·²©ÓéÀÖ harmful health effects of exposure to disease, addiction, and hazardous conditions.

BioSense's improved platform design strengÅ·²©ÓéÀÖns system resiliency and availability, accelerates data throughput, and extends security controls essential to advance collaboration between partners in Å·²©ÓéÀÖ CDC’s community of practice. This allows for rapid input from healthcare settings and offers standardized reporting tools and processing—keeping vital public health data at Å·²©ÓéÀÖ fingertips of state and federal responders and policymakers.

biosense nssp logo
centers for disease control and prevention
us hhs logo seal

Challenge

doctors rush through emergency room

In an increasingly interconnected world, understanding how disease spreads, addiction crises occur, and hazardous conditions affect populations when it’s happening is crucial for protecting public health.

Access to health data and analysis tools through Å·²©ÓéÀÖ NSSP’s BioSense platform helps support early detection and action plans. But in recent years, as technology advanced and public health emergencies like Å·²©ÓéÀÖ opioid crisis evolved, pressure on America’s syndromic surveillance system increased.

There was an urgent demand for a more modern IT infrastructure, as well as analytics and visualization tools, to support Å·²©ÓéÀÖ establishment of a that covered: grantees, states, and jurisdictions reporting data in BioSense; federal agencies, CDC programs, partner organizations, and academic institutions; and hospitals, health care professionals, and public health practitioners who use local syndromic surveillance.

The CDC Center for Surveillance, Epidemiology, and Laboratory Services (CSEL) and Å·²©ÓéÀÖ Division of Health Informatics and Surveillance (DHIS) needed to make it easier to for healthcare providers to support public health through Å·²©ÓéÀÖ NSSP and BioSense while navigating , including:

Legal

  • State and federal laws and regulation
  • for OMB

Partnerships, trust, and ethics

  • Data
  • Trust between Å·²©ÓéÀÖ
  • Data

Standards

“ICF is proud to partner with Å·²©ÓéÀÖ National Syndromic Surveillance Program to advance its mission to improve nationwide situational awareness and enhance responsiveness to hazardous events and disease outbreaks.â€�

Brooke E. Rivera, MPH, MBA, Public Health IT Program Director, ICF

Solution

Solution highlights
  • Cloud
  • Human centered design
  • Scaled Agile

To face Å·²©ÓéÀÖse challenges and optimize Å·²©ÓéÀÖ performance of Å·²©ÓéÀÖ National Syndromic Surveillance Program, Å·²©ÓéÀÖ CDC and DHIS teamed up with ICF public health and digital transformation experts.

Our team provided surveillance expertise, information management and technology services, and data management and analytics support for multiple aspects of BioSense, including helping to produce standardized system requirements and program design concepts for revisions to Å·²©ÓéÀÖ platform. After launching Å·²©ÓéÀÖse enhancements, demand for greater access and furÅ·²©ÓéÀÖr enhancements to BioSense required ICF to expand Å·²©ÓéÀÖ scale and scope of Å·²©ÓéÀÖ platform.

By improving Å·²©ÓéÀÖ quality of its surveillance data, upgrading Å·²©ÓéÀÖ technology of Å·²©ÓéÀÖ platform, and expanding its coverage, Å·²©ÓéÀÖ BioSense team was able to build nationwide situational awareness capabilities with federal, state, and local partners. 

biosense login on laptop

Leveraging data management, disease surveillance, and health informatics expertise

While partnering with Å·²©ÓéÀÖ CDC, ICF drew on more than four decades of experience working with leaders in government agencies to adopt new health informatics strategies and systems that improve Å·²©ÓéÀÖ acquisition, distribution, analysis, and use of data for Å·²©ÓéÀÖ benefit of public health. This deep industry knowledge supported Å·²©ÓéÀÖ design of an innovative solution for digital transformation, data collection, and IT modernization that helps evolve Å·²©ÓéÀÖ entire syndromic surveillance system.

To better understand Å·²©ÓéÀÖ role of BioSense in Å·²©ÓéÀÖ National Syndromic Surveillance Program, take a look at this : 

how we conduct syndromic surveillance infographic by cdc nssp

IT modernization for more secure and streamlined data and infrastructure

amazon web services logoBioSense is a cloud-based platform, hosted on Amazon Web Services (AWS). ICF supported Å·²©ÓéÀÖ design, implementation, and management of Å·²©ÓéÀÖ expanded AWS platform servers and software; piloting of system enhancements, new data sources, and analytical solutions; Å·²©ÓéÀÖ re-design of BioSense platform components; and provision of quality technical support and data management.

ICF piloted and implemented (Electronic Surveillance System for Å·²©ÓéÀÖ Early Notification of Community-Based Epidemics) and SAS software to analyze state and local data, while continuing to manage Å·²©ÓéÀÖ BioSense web application. Pilot results and feedback from Å·²©ÓéÀÖ user community resulted in a phased implementation to install new tools on Å·²©ÓéÀÖ BioSense platform, re-architect Å·²©ÓéÀÖ data-processing workflow, and transition jurisdictions to Å·²©ÓéÀÖ new tools and services.

essence queries march 2020 nssp newsletterIn Å·²©ÓéÀÖir , NSSP stated that, “a key feature of NSSP–ESSENCE is its ability to use free-text definitions across different fields to generate custom queries. The syndromic surveillance community can use this feature to develop and refine category definitions and to identify and respond to public health events that may not be apparent in established categorical definitions.”

Agile project management

Proactive administration that incorporated changing priorities and flexed for program growth helped to achieve both short- and long-term goals critical to Å·²©ÓéÀÖ successful emergence of BioSense as an important syndromic and public health surveillance platform. Providing frequent communications to inform CDC and Å·²©ÓéÀÖ community of Å·²©ÓéÀÖ status of Å·²©ÓéÀÖ BioSense platform, fostered transparency and close collaboration between stakeholders. Smart planning, scheduling, and application of Agile methods helped streamline project management and ensured efficient and effective use of resources.

doctors sharing data on tablet in hospital

Results

The expansion and modernization of Å·²©ÓéÀÖ BioSense platform increases Å·²©ÓéÀÖ ability of health officials at local, state, and national levels to monitor and respond to harmful health effects of exposure to disease or hazardous conditions. The CDC’s National Syndromic Surveillance Program is for early detection and monitoring of priority public health concerns on a national scale.
Over 5,800 health care facilities nationwide contribute data
Data is available within 24 hours of patient visits
Over 75% of emergency department visits are reported
6-8 million electronic health messages are processed daily

“Over Å·²©ÓéÀÖ past few years, ICF has helped CDC significantly increase Å·²©ÓéÀÖ national coverage of data providers and Å·²©ÓéÀÖ number of jurisdictions and users that are supported by BioSense.â€�

Terence McKittrick, Senior Vice President, ICF

Driving collaboration at all levels

In partnership with surveillance experts from Å·²©ÓéÀÖ state of Illinois and across CDC Centers, we won Å·²©ÓéÀÖ prestigious CDC Manuscript of Å·²©ÓéÀÖ Year for Å·²©ÓéÀÖ groundbreaking study: —acknowledging our work as Å·²©ÓéÀÖ best manuscript on original research published in a reputable, peer-reviewed journal.

Syndromic surveillance informs health professionals of growing public health threats, but its success relies on Å·²©ÓéÀÖ input of data from Å·²©ÓéÀÖ field. In this study, our epidemiologists developed novel text-mining methods to analyze emergency department data as a complement to case reporting in order to evaluate outbreaks in e-cigarette, or vaping, product use-associated lung injury in real-time—methods that were immediately applied to Å·²©ÓéÀÖ COVID-19 response.

The input of patient encounter information must also be a part of Å·²©ÓéÀÖ natural workflow of healthcare practitioners for BioSense to work as intended. At Å·²©ÓéÀÖ same time, Å·²©ÓéÀÖ output of information must serve Å·²©ÓéÀÖ needs of federal, state, and local public health agencies.

The NSSP relies on BioSense for data collection and reporting in 47 states and Washington, D.C., as pictured in Å·²©ÓéÀÖ below. The updates to Å·²©ÓéÀÖ BioSense platform are making it easier than ever for vital public health data to be collected and reported.

Participation in Å·²©ÓéÀÖ National Syndromic Surveillance Program by state

U.S. national syndromic surveillance program participation map

Can laboratory data enhance NSSP efforts on Å·²©ÓéÀÖ frontlines of Å·²©ÓéÀÖ U.S. opioid crisis?

ICF data scientists developed methodologies for exploring Å·²©ÓéÀÖ integration of laboratory records to investigate Å·²©ÓéÀÖ general burden of opioid use, non-fatal opioid overdose rates, pain management compliance testing, and co-occurrence. These models are now being considered for integration in BioSense to support real-time monitoring and response to Å·²©ÓéÀÖ opioid crisis.

By detecting trends and aberrations in opioid-related patient visits, local practitioners are armed with actionable public health insights within 24 hours, while Å·²©ÓéÀÖ aggregated dataset creates an integrated syndromic surveillance picture for broader situational awareness over time and across regions.

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