OJPHI: Vol. 5
Journal Information
Journal ID (publisher-id): OJPHI
ISSN: 1947-2579
Publisher: University of Illinois at Chicago Library
Article Information
©2013 the author(s)
open-access: This is an Open Access article. Authors own copyright of their articles appearing in the Online Journal of Public Health Informatics. Readers may copy articles without permission of the copyright owner(s), as long as the author and OJPHI are acknowledged in the copy and the copy is used for educational, not-for-profit purposes.
Electronic publication date: Day: 4 Month: 4 Year: 2013
collection publication date: Year: 2013
Volume: 5E-location ID: e120
Publisher Id: ojphi-05-120

Refactoring INDICATOR into an Advanced Information System for One Health Monitoring
Ian Brooks*12
Mario Felarca1
Bernie A’cs1
1NCSA, Urbana, IL, USA;
2University of Saskatchewan, Saskatoon, SK, Canada
*Ian Brooks, E-mail: ian@ncsa.illinois.edu

Abstract
Objective

To redesign INDICATOR for One Health, establish a common data format, and provide for long term scalability.

Introduction

INDICATOR is a multi-stream open source platform for biosurveillance and outbreak detection, currently focused on Champaign County in Illinois[1]. It has been in production since 2008 and is currently receiving data from emergency departments, patient advisory nurse call center, outpatient convenient care clinic, school absenteeism, animal control, and weather sources. Long term scalability was however compromised during the 2009 H1N1 influenza pandemic as immediate public health needs took priority over our systematic development plan. With the impending addition of veterinary clinic data and recognizing that the health of a community also depends on animal and environmental factors, we decided to revisit the INDICATOR architecture and redesign it to be a more holistic and scalable system. We also decided to revisit the data submission format, keeping in line with the philosophy of making opportunistic secondary use of as much data about the health of a community that we can obtain.

Methods

Following a formal evaluation of the existing production version of INDICATOR we established the systems architecture shown in Figure 1 to leverage work in other cyberinfrastructure projects at NCSA.

Results

We have now implemented the back end changes, including unifying the multiple physical MySQL database systems and multiple Apache Tomcat application engines into a single system. A web application, using service oriented principles and the GWT library, has been developed that can query and display the newly unified data and provide new options for input of data to the system.

In order to streamline and simplify the data format we decided to define a single format that can be used by different kinds of healthcare providers, both human and veterinary. Although we recognize the limitations in this approach we define a reported event to be a simple what, when, and where containing the following seven fields or the relevant subset based roughly on the ISDS meaningful use recommendations [2]

  1. Date of incident
  2. ICD-9 code for the primary diagnosis
  3. Free text of the diagnosis (not the text definition of the ICD-9 code)
  4. Text chief complaint at triage
  5. Location
  6. Count
  7. Species

In this way we can handle, in a single format, data from emergency departments, convenient care clinics, patient advisory nurse call centers, veterinary clinics, veterinary labs, and veterinary poison control centers.

Conclusions

INDICATOR has been significantly redesigned and is now more integrated, scalable, and secure. It is now placed to become a One Health integrated monitoring system.


Acknowledgments

We would like to thank Carle Foundation, Christie Clinic, Champaign County animal control, Champaign County Humane Society, the Veterinary Medicine Data Base, and schools in Champaign County for sharing their data. We would also like to thank Julie Pryde and Awais Vaid, from Champaign-Urbana Public Health District for their ongoing support and assistance.


References
[1]. Brooks I, Edwards W. INDICATOR: A Cyberenvironment for Biosurveillance and ResponseSyndromic. 2009
[2]. ISDS Meaningful Use Recommendations

Figures
ojphi-05-120f1.tif
[Figure ID: f1-ojphi-05-120]
Figure 1 

INDICATOR system architecture



Article Categories:
  • ISDS 2012 Conference Abstracts

Keywords: Open Source, Surveillance, Informatics, One Health.




Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org