142nd APHA Annual Meeting and Exposition

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Enhancement of sentinel surveillance for influenza-like illness through electronic medical record data aggregation and GIS-mapping by community in Williamson County, Texas

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Virginia Headley, PhD , Disease Control and Prevention, Williamson County & Cities Health District, Georgetown, TX
Emily Styles, MPH , Lone Star Circle of Care, Austin, TX
Background: Williamson County and Cities Health District (WCCHD) collects voluntary information from a variety of sentinel provider sources on both laboratory-confirmed influenza and incidences of influenza-like illness (ILI).  Lone Star Circle of Care (LSCC) is a Federally Qualified Health Center whose headquarters are in Williamson County.  Methods:  Using SQL database programming, LSCC extracted data from its electronic medical record (EMR) to identify patients presenting with symptoms meeting the definition of ILI.    From June 2012 to September 2013 LSCC submitted weekly reports to WCCHD which included data on total patient visits and visits due to ILI.  Data were aggregated by zip code, sex, age group, and pregnancy status.  WCCHD aggregated zip code data into five “communities” and mapped relative severity of ILI (minimal to intense) in each community using ArcGIS.  Results:  Age distribution of LSCC patients differed from the general population of Williamson County with a significant shift to the pediatric population. ILI encounters  occurred primarily in the pediatric population (1-17 years of age).  Rural areas of the county were the first to reach a moderate level of ILI in week 39 of 2012, and the last to experience moderate ILI at the end of the season in week 15 of 2013.  Throughout the 2012-2013 influenza season, ILI incidence was minimal in women aged 18-49 years (301 ILI visits in 37,193 total encounters), and it was exceptionally low in those who were pregnant (only 12 ILI visits in 11,527 total obstetric encounters). Aggregated LSCC EMR data was found to be a useful tool for local community and population-level situational awareness throughout the influenza season.

Learning Areas:


Learning Objectives:
Assess the utility of demographically aggregated county-level data for influenza surveillance. Discuss GIS-mapping strategies for demonstrating relative influenza-like illness incidence.

Keyword(s): Data Collection and Surveillance, Geographic Information Systems (GIS)

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal epidemiologist at a local health department for two years, was a public health epidemiology consultant for five years on multiple federally funded projects, and completed an emerging infectious diseases post-doctoral fellowship with the Centers for Disease Control and Prevention. My primary scientific interests include data collection systems, surveillance, and analysis to develop evidence-based public health interventions for the prevention and control of infectious diseases.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.