{"pk":15285,"title":"Cloud-Based Influenza Surveillance System in Emergency Departments Using Molecular-Based Testing: Advances and Challenges","subtitle":null,"abstract":"Introduction:\n Electronic influenza surveillance systems aid in health surveillance and clinical decisionmaking within the emergency department (ED). While major advances have been made in integrating  clinical decision-making tools within the electronic health record (EHR), tools for sharing surveillance  data are often piecemeal, with the need for data downloads and manual uploads to shared servers,  delaying time from data acquisition to end-user. Real-time surveillance can help both clinicians and public  health professionals recognize circulating influenza earlier in the season and provide ongoing situational  awareness.\nMethods:\n We created a prototype, cloud-based, real-time reporting system in two large, academically  affiliated EDs that streamed continuous data on a web-based dashboard within hours of specimen  collection during the influenza season. Data included influenza test results (positive or negative) coupled  with test date, test instrument geolocation, and basic patient demographics. The system provided  immediate reporting to frontline clinicians and to local, state, and federal health department partners.\nResults:\n We describe the process, infrastructure requirements, and challenges of developing and  implementing the prototype system. Key process-related requirements for system development included  merging data from the molecular test (GeneXpert) with the hospitals’ EHRs, securing data, authorizing/ authenticating users, and providing permissions for data access refining visualizations for end-users.\nConclusion:\n In this case study, we effectively integrated multiple data systems at four distinct hospital  EDs, relaying data in near real time to hospital-based staff and local and national public health entities,  to provide laboratory-confirmed influenza test results during the 2014-2015 influenza season. Future  innovations need to focus on integrating the dashboard within the EHR and clinical decision tools.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Surveillance, Emergency department, Flu"}],"section":"Endemic Infections","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6017j3w4","frozenauthors":[{"first_name":"Bhakti","middle_name":"","last_name":"Hansoti","name_suffix":"","institution":"Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland","department":"None"},{"first_name":"Kathryn","middle_name":"","last_name":"Shaw-Saliba","name_suffix":"","institution":"Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland","department":"None"},{"first_name":"Howard","middle_name":"","last_name":"Burkom","name_suffix":"","institution":"Applied Physics Laboratory, Johns Hopkins University, Laurel, Maryland","department":"None"},{"first_name":"Diego","middle_name":"A.","last_name":"Martinez","name_suffix":"","institution":"Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland\nSchool of Industrial Engineering, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile","department":"None"},{"first_name":"Anna","middle_name":"","last_name":"DuVal","name_suffix":"","institution":"Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland","department":"None"},{"first_name":"Brian","middle_name":"","last_name":"Lee","name_suffix":"","institution":"Office of the Chief Information Officer, Office of the Chief Operating Officer, Centers for Disease Control and Prevention, Atlanta, Georgia\nDepartment of Engineering and Software, Cepheid, Sunnyvale, California","department":"None"},{"first_name":"Phong","middle_name":"","last_name":"Chau","name_suffix":"","institution":"Biomedical Advanced Research and Development Authority, US Department of Health and Human Services, Washington, District of Columbia","department":"None"},{"first_name":"Breanna","middle_name":"","last_name":"McBride","name_suffix":"","institution":"Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland","department":"None"},{"first_name":"Yu-Hsiang","middle_name":"","last_name":"Hsieh","name_suffix":"","institution":"Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland","department":"None"},{"first_name":"Vidiya","middle_name":"","last_name":"Sathananthan","name_suffix":"","institution":"Johns Hopkins University School of Medicine, Department of Emergency Medicine, Baltimore, Maryland","department":"None"},{"first_name":"Andrea","middle_name":"","last_name":"Dugas","name_suffix":"","institution":"Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland","department":"None"},{"first_name":"Richard","middle_name":"E","last_name":"Rothman","name_suffix":"","institution":"","department":"None"},{"first_name":"David","middle_name":"","last_name":"Persing","name_suffix":"","institution":"Biomedical Advanced Research and Development Authority, US Department of Health and Human Services, Washington, District of Columbia","department":"None"},{"first_name":"Michael","middle_name":"","last_name":"Turnlund","name_suffix":"","institution":"Biomedical Advanced Research and Development Authority, US Department of Health and Human Services, Washington, District of Columbia","department":"None"},{"first_name":"Roxanne","middle_name":"","last_name":"Shively","name_suffix":"","institution":"","department":"None"}],"date_submitted":"2021-04-10T14:25:02Z","date_accepted":"2021-04-10T14:25:02Z","date_published":"2022-02-14T22:56:50Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/15285/galley/7752/download/"}]}