Biomedical subjects

Jeremy U Espino

Publications and source records attributed to Jeremy U Espino.

10 recordsLinked to original sources

PubMed2005

Key design elements of a data utility for national biosurveillance: event-driven architecture, caching, and Web service model.

The National Retail Data Monitor (NRDM) has monitored over-the-counter (OTC) medication sales in the United States since December 2002. The NRDM collects data from over 18,600 retail stores and processes over 0.6 million sales records per day. This paper describes key architectural features that we have found necessary for a data utility component in a national biosurveillance system. These elements include event-driven architecture to provide analyses of data in near real time, multiple levels of caching to improve query response time, high availability through the use of clustered servers, scalable data storage through the use of storage area networks and a web-service function for interoperation with affiliated systems. The methods and architectural principles are relevant to the design of any production data utility for public health surveillance-systems that collect data from multiple sources in near real time for use by analytic programs and user interfaces that have substantial requirements for time-series data aggregated in multiple dimensions.

Commerce↗

PubMed2004

Removing a barrier to computer-based outbreak and disease surveillance--the RODS Open Source Project.

INTRODUCTION: Computer-based outbreak and disease surveillance requires high-quality software that is well-supported and affordable. Developing software in an open-source framework, which entails free distribution and use of software and continuous, community-based software development, can produce software with such characteristics, and can do so rapidly. OBJECTIVES: The objective of the Real-Time Outbreak and Disease Surveillance (RODS) Open Source Project is to accelerate the deployment of computer-based outbreak and disease surveillance systems by writing software and catalyzing the formation of a community of users, developers, consultants, and scientists who support its use. METHODS: The University of Pittsburgh seeded the Open Source Project by releasing the RODS software under the GNU General Public License. An infrastructure was created, consisting of a website, mailing lists for developers and users, designated software developers, and shared code-development tools. These resources are intended to encourage growth of the Open Source Project community. Progress is measured by assessing website usage, number of software downloads, number of inquiries, number of system deployments, and number of new features or modules added to the code base. RESULTS: During September--November 2003, users generated 5,370 page views of the project website, 59 software downloads, 20 inquiries, one new deployment, and addition of four features. CONCLUSIONS: Thus far, health departments and companies have been more interested in using the software as is than in customizing or developing new features. The RODS laboratory anticipates that after initial installation has been completed, health departments and companies will begin to customize the software and contribute their enhancements to the public code base.

Disease Outbreaks↗

PubMed2004

The RODS Open Source Project: removing a barrier to syndromic surveillance.

The goal of the Real-time Outbreak and Disease Surveillance (RODS) Open Source Project is to accelerate deployment of computer-based syndromic surveillance. To this end, the project has released the RODS software under the GNU General Public License and created an organizational structure to catalyze its development. This paper describes the design of the software, requested extensions, and the structure of the development effort.

Algorithms↗

PubMed2003

Automated syndromic surveillance for the 2002 Winter Olympics.

The 2002 Olympic Winter Games were held in Utah from February 8 to March 16, 2002. Following the terrorist attacks on September 11, 2001, and the anthrax release in October 2001, the need for bioterrorism surveillance during the Games was paramount. A team of informaticists and public health specialists from Utah and Pittsburgh implemented the Real-time Outbreak and Disease Surveillance (RODS) system in Utah for the Games in just seven weeks. The strategies and challenges of implementing such a system in such a short time are discussed. The motivation and cooperation inspired by the 2002 Olympic Winter Games were a powerful driver in overcoming the organizational issues. Over 114,000 acute care encounters were monitored between February 8 and March 31, 2002. No outbreaks of public health significance were detected. The system was implemented successfully and operational for the 2002 Olympic Winter Games and remains operational today.

Algorithms↗

PubMed2003

Technical description of RODS: a real-time public health surveillance system.

This report describes the design and implementation of the Real-time Outbreak and Disease Surveillance (RODS) system, a computer-based public health surveillance system for early detection of disease outbreaks. Hospitals send RODS data from clinical encounters over virtual private networks and leased lines using the Health Level 7 (HL7) message protocol. The data are sent in real time. RODS automatically classifies the registration chief complaint from the visit into one of seven syndrome categories using Bayesian classifiers. It stores the data in a relational database, aggregates the data for analysis using data warehousing techniques, applies univariate and multivariate statistical detection algorithms to the data, and alerts users of when the algorithms identify anomalous patterns in the syndrome counts. RODS also has a Web-based user interface that supports temporal and spatial analyses. RODS processes sales of over-the-counter health care products in a similar manner but receives such data in batch mode on a daily basis. RODS was used during the 2002 Winter Olympics and currently operates in two states-Pennsylvania and Utah. It has been and continues to be a resource for implementing, evaluating, and applying new methods of public health surveillance.

Algorithms↗

PubMed2003

Design of a national retail data monitor for public health surveillance.

The National Retail Data Monitor receives data daily from 10,000 stores, including pharmacies, that sell health care products. These stores belong to national chains that process sales data centrally and utilize Universal Product Codes and scanners to collect sales information at the cash register. The high degree of retail sales data automation enables the monitor to collect information from thousands of store locations in near to real time for use in public health surveillance. The monitor provides user interfaces that display summary sales data on timelines and maps. Algorithms monitor the data automatically on a daily basis to detect unusual patterns of sales. The project provides the resulting data and analyses, free of charge, to health departments nationwide. Future plans include continued enrollment and support of health departments, developing methods to make the service financially self-supporting, and further refinement of the data collection system to reduce the time latency of data receipt and analysis.

Algorithms↗

PubMed2003

Telephone triage: a timely data source for surveillance of influenza-like diseases.

We evaluated telephone triage (TT) data for public health early warning systems. TT data is electronically available and contains coded elements that include the demographics and description of a caller's medical complaints. In the study, we obtained emergency room TT data and after hours TT data from a commercial TT software and service company. We compared the timeliness of the TT data with influenza surveillance data from the Centers for Disease Control using the cross correlation function. Emergency room TT calls are one to five weeks ahead of surveillance data collected by the CDC.

Disease Outbreaks↗

PubMed2002

Rapid deployment of an electronic disease surveillance system in the state of Utah for the 2002 Olympic Winter Games.

The key to minimizing the effects of an intentionally caused disease outbreak is early detection of the attack and rapid identification of the affected individuals. The Bush administration's leadership in advocating for biosurveillance systems capable of monitoring for bioterrorism attacks suggests that we should move quickly to establish a nationwide early warning biosurveillance system as a defense against this threat. The spirit of collaboration and unity inspired by the events of 9-11 and the 2002 Olympic Winter Games in Salt Lake City provided the opportunity to demonstrate how a prototypic biosurveillance system could be rapidly deployed. In seven weeks we were able to implement an automated, real-time disease outbreak detection system in the State of Utah and monitored 80,684 acute care visits occurring during a 28-day period spanning the Olympics. No trends of immediate public health concern were identified.

Bioterrorism↗

PubMed2002

Data, network, and application: technical description of the Utah RODS Winter Olympic Biosurveillance System.

Given the post September 11th climate of possible bioterrorist attacks and the high profile 2002 Winter Olympics in the Salt Lake City, Utah, we challenged ourselves to deploy a computer-based real-time automated biosurveillance system for Utah, the Utah Real-time Outbreak and Disease Surveillance system (Utah RODS), in six weeks using our existing Real-time Outbreak and Disease Surveillance (RODS) architecture. During the Olympics, Utah RODS received real-time HL-7 admission messages from 10 emergency departments and 20 walk-in clinics. It collected free-text chief complaints, categorized them into one of seven prodromes classes using natural language processing, and provided a web interface for real-time display of time series graphs, geographic information system output, outbreak algorithm alerts, and details of the cases. The system detected two possible outbreaks that were dismissed as the natural result of increasing rates of Influenza. Utah RODS allowed us to further understand the complexities underlying the rapid deployment of a RODS-like system.

Algorithms↗

PubMedDate not supplied

Roundtable on bioterrorism detection: information system-based surveillance.

During the 2001 AMIA Annual Symposium, the Anesthesia, Critical Care, and Emergency Medicine Working Group hosted the Roundtable on Bioterrorism Detection. Sixty-four people attended the roundtable discussion, during which several researchers discussed public health surveillance systems designed to enhance early detection of bioterrorism events. These systems make secondary use of existing clinical, laboratory, paramedical, and pharmacy data or facilitate electronic case reporting by clinicians. This paper combines case reports of six existing systems with discussion of some common techniques and approaches. The purpose of the roundtable discussion was to foster communication among researchers and promote progress by 1) sharing information about systems, including origins, current capabilities, stages of deployment, and architectures; 2) sharing lessons learned during the development and implementation of systems; and 3) exploring cooperation projects, including the sharing of software and data. A mailing list server for these ongoing efforts may be found at http://bt.cirg.washington.edu.

Bioterrorism↗