Surveillance Systems in Patient Care and Clinical Decision-making

by Rhonda Lawes, PhD, RN

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    00:00 Today, we're going to talk about the power of local, regional, national and international surveillance systems and how we use them to make clinical decisions for individuals and the entire world.

    00:13 Surveillance systems like the National Syndromic Surveillance Program or the NSSP, they're the vigilant sentinels of our healthcare ecosystem. Now, these systems monitor health data to detect, prevent and respond to disease outbreaks.

    00:32 They are instrumental in disaster response and planning.

    00:36 They act as a lighthouse during a storm, kind of guiding our responses and our strategies. Now, like with any other technology, there are different types of surveillance systems and different terminology to describe them.

    00:49 A syndromic surveillance system uses two things, both active and passive. Active is a collection of specific real-time data and passive is waiting on routinely submitted reports.

    01:02 We use these to mobilize a rapid response when disaster happens so these systems monitor illness clusters or impact of weather or other disasters early.

    01:15 Now this is before patients are officially cared for and given diagnoses by the medical providers.

    01:22 This real-time data can be used to make decisions and reduce morbidity and mortality.

    01:29 For example, these systems were incredibly important when COVID 19 first appeared, first de-identified ed records, their chief complaint and their discharge diagnosis.

    01:42 Next, medical examiner reports this was the cause of death or increases in volumes by region.

    01:50 Clinical lab volumes, types and amounts of tests being run was another indicator.

    01:56 Now the information and data pieces were continuously being verified and used for dashboard applications.

    02:03 Now these are what enabled media outlets, private and public consumers, to see and to understand across regions, countries and the world what was happening with Covid 19.

    02:15 Now, these systems sound amazing.

    02:18 However, there are some challenges of these systems that the informatics professional needs to consider.

    02:24 First of all, systems have the ability not only to talk and listen, but also to understand each other.

    02:32 How people input data changes, how the system can organize it.

    02:37 It takes considerable time, financial and human resources, to transition systems to using electronic rather than the human-centric structured data collection and input systems.

    02:49 Next, a significant challenge is the integration of complex and siloed systems.

    02:56 Now these are often governed and funded independently.

    03:00 All members of the team, from senior management to the end user need to be invested in creating the most usable, goal-oriented systems possible by identifying the ways electronic information can be managed and used for the maximum benefit.

    03:16 Increasing adoption of electronic health records and health information exchange systems is of great benefit to the power of the surveillance system to increase this power.

    03:27 The Centers for Medicare and Medicaid Services, CMS, dictate that public health agencies have to electronically submit data significant to public health, such as immunization registry and communicable disease data.

    03:42 Before we move on to another concept, let's review with an informatics perspective.

    03:47 Consider how your healthcare organization can make better clinical decisions with these tools.

    03:53 Surveillance systems provide valuable data or clues that can guide clinicians in making informed decisions or enhancing patient care and ultimately improving public health outcomes.

    04:06 For instance, real-time syndromic surveillance data can alert clinicians to emerging health threats such as disease outbreaks, which allows them to take immediate action.

    04:18 Imagine working in a busy urban emergency room and you have a client who presents with signs and symptoms of a foodborne illness.

    04:26 You ask yourself, Is this isolated to the person or related to a community source like contaminated food from a restaurant or grocery store? Checking surveillance systems can answer that question for you.

    04:40 Let's take a look at a surveillance system resource from the Centers of Disease Control and consider how it can be used to manage this patient.

    04:49 Control and consider how it can be used to manage this patient.

    04:50 This is the CDC's website.

    04:52 If you're curious about whether this patient's situation is unique or part of outbreaks, just scroll down and click on the foodborne outbreaks. Once you're here, the first thing you'll notice is a major outbreak warning at the top of the screen.

    05:08 Now, this is great information for you to know when evaluating every patient who presents with any GI symptom.

    05:15 However, if you're curious about current or specific outbreaks and whether your patient might be affected by it, simply scroll down and click on current and past foodborne outbreaks.

    05:28 Once you're there, you'll hopefully find all the information you might need.

    05:33 But what if you think the outbreak is regional to just your area and you're not sure what to do? In those cases, you can click here and follow these steps.

    05:44 Here, you'll find all the information you need organized in a comprehensive and easy-to-follow manner.

    05:52 So I encourage you to explore the site on your own.

    05:54 Just download the materials from this video and you can navigate through all of this by yourself.

    About the Lecture

    The lecture Surveillance Systems in Patient Care and Clinical Decision-making by Rhonda Lawes, PhD, RN is from the course Healthcare Informatics.

    Included Quiz Questions

    1. Reports submitted from local public health agencies about outbreak numbers.
    2. Calling local hospitals to obtain information on disease outbreaks.
    3. Screening clients for disease symptoms.
    4. Having clients fill out a survey about risk factors with their healthcare provider.
    1. Integration of complex systems to ensure data is understood.
    2. Client identifiers like name and address on all data.
    3. Relying solely on active data collection.
    4. Encouraging health systems to submit paper reports instead of electronic records.
    1. Check the Center for Disease Control’s website for current foodborne illness outbreaks.
    2. Call the grocery store the client went to and ask if the chicken had been recalled.
    3. Call the company that supplied the chicken to the grocery store and ask if there has been a recall.
    4. Use a search engine to see if there have been any reports of foodborne illness in the area.

    Author of lecture Surveillance Systems in Patient Care and Clinical Decision-making

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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