Enhanced Influenza and Respiratory Virus Surveillance During the 2009 H1N1 Influenza Outbreak

In response to H1N1 outbreak, we rapidly and iteratively developed a series of automated surveillance reports designed to provide key stake holders and decision makers with timely information about Influenza A and other viral respiratory infections. The target audience included public health officials, health care delivery system leaders, hospital infection control, infectious disease experts and front line care providers. The reports included: 1) a daily Influenza A surveillance summary, 2) a daily respiratory surveillance / viral testing summary and 3) a daily detailed Influenza A case report summary, which included markers of severe illness. Our primary data source was the pathogen-specific and laboratory-based surveillance infrastructure we have developed using the enterprise data warehouse of a large integrated health care delivery network. Data from the laboratory information system about confirmed cases of respiratory viruses were combined with data from the clinical information system to provide detailed information about individual cases. The detailed Influenza A case report included: demographics, testing details (methods, collection date/times, facility), hospitalization status, hospital unit, diagnosis of pneumonia, need for mechanical ventilation or intensive care. The Cognos business intelligence platform was used for generation and dissemination of these reports. This platform provides tools for report automation, e-mail distribution lists and rendering of content suitable for web publication. A HIPAA waiver from public health authorized the dissemination of detailed patient reports to key stakeholders (i.e., public health, hospital infection control and senior leadership). De-identified daily surveillance reports were also posted to a web site dedicated to communicating information about novel H1N1 influenza and other respiratory viral activity to front line providers and employees. This presentation will cover the methods, application and a formative evaluation of the impact these enhanced reports had on the management and response to the H1N1 outbreak.