The SIDARTHa surveillance approach Kingston Canada June 13

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The SIDARTHa surveillance approach Kingston, Canada June 13, 2008

The SIDARTHa surveillance approach Kingston, Canada June 13, 2008

The European Emergency Data Group Research Network

The European Emergency Data Group Research Network

European Emergency Data (EED) Group Research Network Loosely formed research network of European health

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 Network Activities 1996 -2000: EED I & II - Comparing

EED Group - Research Network Activities 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)

EED Group - Research Network Output 1996: Krafft, T. and L. García Castrillo-Riesgo (ed.

EED Group - Research Network Output 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. 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.

SIDARTHa The European Project

SIDARTHa The European Project

General Objectives to contribute to and to enhance the generic preparedness of the health

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.

Project Overview PHASE I - Conceptualisation PHASE II - Implementation Information Implementation Possibilities Needs

Project Overview PHASE I - Conceptualisation PHASE II - Implementation Information Implementation Possibilities Needs Project Coordination Dissemination of Project Results Project Evaluation

Administrative Project Structure WP 1 - Project Coordination WP 2 - Dissemination of Project

Administrative Project Structure WP 1 - Project Coordination WP 2 - Dissemination of Project Results WP 3 - Project Evaluation PHASE I - Conceptualisation WP 4 Best practice local practice WP 5 EM databased surveillance WP 6 Design & Callibration Workshop + Steering Committee Meeting only WP Work Package M Month of project time PHASE II - Implementation WP 7 Pilot Phase

Specific Objectives 1. Assessment of best and local practice of emergency data-based surveillance 2.

Specific Objectives 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

State Centre Tyrol, of. Innsbruck/Austria Dispatch Hospitals of County Goeppingen, Goeppingen/Germany Project Group Gernot

State Centre Tyrol, of. Innsbruck/Austria Dispatch Hospitals of County Goeppingen, Goeppingen/Germany Project Group Gernot Vergeiner Matthias Fischer Federal Government, Department of Service, Public Health, Organisation of National Emergency Medical Budapest/Hungary Care Institutions, Gabor Göbl. Brussels/Belgium Agnes Meulemans San Martino University Hospital, Genoa/Italy Riesgo (Spain) Prof. Dr. Luis Garcia-Castrillo Emergency Medical Service Prague/Czech Republic Francesco Bermano àemergency medicine, leader of a district EMS, emergency data analysis Milana Pokorna Haukeland University Hospital, Bergen/Norway Dr. Thomas Krafft (Germany) Universitad de Cantabria (Spain) – Public Financial issues Capital Guttorm Region of Denmark, Devision of Planning and Prof. Dr. Helmut Brand – Professor for Development, European Health, Heademergency of Brattebo àhealth geography, experience in leading an EMS system, Copenhagen/Denmark Department International Health, Faculty of Health, Medicine & Life Sciences, dataofanalysis, GIS/spatial-temporal analyses, EED Project leader Geomed Research Gmb. H (Germany) – Technical issues Freddy Lippert University of Maastricht, Netherlands University of Cantabria, Santander/Spain 2 – GEOMED DE – Methodology data processing, analysis, reporting Luis Castrillo Prof. Dr. Freddy Lippertof (Denmark) Dr. Enrico Davoli of - Programme Manager, Health Organization Regional University Hospital, Department Anaesthesiology and. World Intensive àemergency medicine, national health authority representative, medical Subcontracting partners – Technical programming of data transfer, Office for Europe, Department for Emergency Medical Services, Barcolona/Spain Care, Kuopio/Finland University Hospital, Antalya/Turkey director of regional EMS processing, analysis, reporting Jouni Kurola Hakan Yaman Prof. Dr. Javier Llorca - Professor for Public Health and Epidemiology, University Ing. Gernot Vergeiner (Austria) of Cantabria, Santander/Spain SATYAM Computer Services, Inc. Hyderabad/India Emergency Medical Service for Province Hauts EMS dispatch, leader de of a. Seine, high-performance state dispatch centre, Jerry Overton, MA Director, Richmond Ambulance Authority, USA; first site in Garches/France emergency data analysis the USA that implemented the emergency data-based surveillance system First Michel Baer Watch™Prof. in 2002 Dr. Matthias Fischer (Germany) Emergency data of analysis, of a state Dr. Santiago Rodriguezmedicine, - Director, emergency Health Service Districtorganiser of Cantabria, emergency medicine registry Santander/Spain Prof. Dr. Prof. Mark. Dr. Rosenberg - Professor of Geography & Professor of Community Alexander Krämer (Germany) Health and Epidemiology, Queen’s University, Kingston/Canada Public health, epidemiology/biometry, internal medicine, health surveillance N. N. - DG SANCO (Health Threat Unit) & ECDC to be nominated by institutions

The European Health Surveillance Complex

The European Health Surveillance Complex

EU surveillance concept

EU surveillance concept

European Health Emergency Network - Actors Other European Commission’s Directorates General European Commission’s Directorate

European Health Emergency Network - Actors Other European Commission’s Directorates General European Commission’s Directorate General Health and Consumers European Centre for Disease Prevention and Control European Commission’s Health Threat Unit (HTU) Emergency Operations Centre Health Emergency Operations Facility (HEOF) 27 EU Member States Health Ministries World Health Organization Regional Office for Europe

European Health Surveillance / Alert Network Other European Commission’s Directorates General Other Alert Systems

European Health Surveillance / Alert Network Other European Commission’s Directorates General Other Alert Systems European Commission’s Directorate General Health and Consumers European Centre for Disease Prevention and Control Dedicated Surveillance Networks / TESSy EWRS/Rapid Alert Systems Med. ISys 27 EU Member States Health Ministries World Health Organization Regional Office for Europe National Surveillance Systems CISID / GOARN

DSN – Dedicated Surveillance Networks BSN = Basic Surveillance Network DIPNET = The Diphtheria

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 Euro. CJD = European Creutzfeldt Jakob Disease Surveillance Euro. HIV = European Centre for the Epidemiological Monitoring of AIDS Euro. TB = 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

EWRS – Early Warning and Response System

Med. ISys – Medical Intelligence System

Med. ISys – Medical Intelligence System

SIDARTHa The Anticipated Surveillance System

SIDARTHa The Anticipated Surveillance System

Intended System Design Med. ISys European Health Surveillance System Automatic Data Processing/ Analysis Emergency

Intended System Design Med. ISys European Health Surveillance System Automatic Data Processing/ Analysis Emergency Professionals Risk Communication Platform EWRS Website Automatic Data Transfer DSN/ RAS Alert Communication/ Support DSN EWRS Dedicated Surveillance Network (disease specific) Intelligence System RAS Rapid Alert Systems, e. g. , RAS-CHEM (chemical emergency) Local Health Surveillance System Hospital A EMS A Hospital B EMS B National Health Authority Early Warning & Response System Med. ISys Medical Local Health Surveillance System Local Health Authority

Intended System Design – Local Level Emergency Professionals Risk Communication Platform European Health Surveillance

Intended System Design – Local Level Emergency Professionals Risk Communication Platform European Health Surveillance System Local Health Surveillance System Automatic Comparison with Threshold GIS-based Automatic Generation of Spatial-Temporal Thresholds Automatic Syndrome Generation Automatic Historical Data Analysis Automatic Data Cleansing Local Health Authority EMS A

Intended System Design – European Level Emergency Professionals Risk Communication Platform European Health Surveillance

Intended System Design – European Level Emergency Professionals Risk Communication Platform European Health Surveillance System European Report / Alert National Report / Alert Local Report / Alert A B C D 6 9 7 3 9 2 8 4 GIS-based Analysis Tool Local Health Surveillance System

SIDARTHa – System‘s Strengths Local surveillance unit based at single institution Aggregation level low:

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!

Thank you!