Community of Practice Updates

Updated June 15, 2023

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Policy for Federal Access to NSSP Data

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During the November 2022 CoP Monthly meeting, Acting NSSP Lead Karl Soetebier informed the community of efforts to make NSSP data more accessible and to improve collaboration toward common goals.

In early December 2022, Soetebier updated site administrators of NSSP’s ongoing work related to data use. He explained how expanded access to NSSP data during the COVID-19 public health emergency enabled innovation in areas such as trend indicators and classification, anomaly detection, and text mining by age and geography. The ability to work this way routinely, outside the context of a public health emergency, is not permitted by the current data use agreement.

In early 2023, to build on public health response innovations and to continue to enhance data use, CDC began designing a new NSSP agreement to incorporate lessons learned from the COVID-19 response, enable close collaboration between sites and CDC, enable new innovations and services for sites, and maximize responsible use of data and provide timelier synthesis of findings and recommendations. Further, this agreement would help respond to the top concerns raised by public health departments in the Review of Federal Access to National Syndromic Surveillance Program Data: Findings and Implementation Strategies, posted by the Council of State and Territorial Epidemiologists (CSTE) in February 2023.

CDC has made a thoughtful choice to change from a data use agreement (DUA) to a memorandum of understanding (MOU) to better reflect the collaborative nature of the agreement. By refocusing the DUA as an MOU, the collaborative and participatory goals of the partnership across federal, state, and local public health authorities become more transparent. Details of the DUA/MOU are being worked through.

NSSP CoP Monthly Meeting

The National Syndromic Surveillance Program (NSSP) Community of Practice (CoP) met on May 24, 2023. On average, 100 to 120 people participate in these monthly meetings. Recordings for CoP monthly calls are posted in the Knowledge Repository. The June NSSP CoP monthly call is cancelled because the 2023 CSTE Annual Conference is being held June 25–29, 2023.

Syndromic Surveillance for Mass Gathering Events

William Smith with the Maricopa County, Arizona Department of Public Health (MCDPH), presented on mass gathering event surveillance using syndromic surveillance. Maricopa County is one of the largest counties in the United States and hosts large events such as the Waste Management Open PGA tournament and, earlier this year, the Super Bowl.

Syndromic surveillance for these events relies specifically on pre-diagnostic symptoms and chief complaints that are assessed via a 50-question survey administered to those seeking care at a first aid tent. The survey is broken down into four main categories including visit classification, illness, injury, and general information. The visit classification determines if the patient is being seen for an injury, illness, or other reason. When patients are seen for an illness, they are asked about their symptoms including what types of symptoms they’re experiencing, when symptoms began, and what caused those symptoms. When patients are being seen for injuries, they are asked about when and where the injury occurred, whether it was intentional or unintentional, and information about the type of injury. Patient surveys are anonymous and voluntary. The results of this type of syndromic surveillance have led to prevention of injury due to uneven floors and early detection of disease clusters and helped to address reports of lack of water and sunscreen for future events.

Additionally, MCDPH partners with the Arizona Department of Health Services (ADHS) to use ESSENCE dashboards to inform surveillance efforts for mass gathering events. In addition to common syndromes found in ESSENCE, MCDPH has developed event-specific queries that search free-text fields for the event name, team or performer names, hazmat queries, chemical exposure discharge diagnosis (DD) queries, burn and corrosion DD queries, radiological rule-out queries, and radiological isotope queries. MCDPH and ADHS also collaborate to check data quality, completeness, and timeliness of data during these events.

The presentation is available on the NSSP CoP Knowledge Repository here.

Wildfire Surveillance

Anna Frick (AK), Kacey Potis (WA), Carola Trenga (OR), and Kelly Cogswell (OR) presented and led a discussion on wildfire surveillance using syndromic surveillance data. They began their discussion by introducing the need for surveillance of respiratory conditions, cardiovascular conditions, and burns. Additionally, they mentioned the importance of monitoring air quality, which can be done with ESSENCE air quality data from the National Oceanic and Atmospheric Administration (NOAA) and in collaboration with state teams that create wildfire maps. ESSENCE also contains queries and dashboards that are helpful for wildfire surveillance.

The presenters shared recommendations for other CoP members based on their experience. The first recommendation is to start all activities early. This includes setting up “micro-regions” based on what makes sense for a given public health jurisdiction. For example, WA has created east and west regions of the state based on the mountain range that divides the state. Other recommendations are to test queries on past fires or past days with poor air quality, learn where wildfire monitoring stations are located, and build ESSENCE dashboards to easily view data. Finally, they recommended that public health staff identify ways to effectively communicate findings to partners to inform public health action. Some examples provided include developing surveillance reports, maps, and seasonal hazard dashboards for the public.

The presentation is available on the NSSP CoP Knowledge Repository here.

Reminders and Announcements

  • Join the Community and a subcommittee! Our Community is a great way to meet others working in syndromic surveillance and advance the work of syndromic surveillance at all jurisdictional levels. Become part of the Community or update your NSSP CoP membership to join a subcommittee here. Encourage others to join, too!
    • Join and participate in the Slack workspace. This space is full of rich discussion among colleagues. This is a great opportunity to collaborate with your peers outside of CoP meetings.
    • Submit success stories to be featured in NSSP Update and on the NSSP CoP website. You do great work every day that we want to highlight.
    • Submit a topic for future NSSP CoP monthly calls. These calls are meant for the community, and we want to know what is most important to you.
  • CSTE Annual Conference 2023: Meet, build relationships, and network with colleagues and experts in areas including informatics, infectious diseases, substance use, chronic disease, and injury control. Join more than 2,500 public health epidemiologists from across the nation in workshops, plenary sessions, oral breakout sessions, roundtable discussions, and poster presentations. The plan is to hold conference sessions in person; however, CSTE will monitor circumstances and public health recommendations of group gatherings.
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Spotlight on NSSP at the 2023 CSTE Annual Conference

The CSTE Annual Conference 2023 (June 25–29) connects public health epidemiologists from across the country to share best practices. Mark your calendars for the following presentations to get updates and insights about NSSP.

Monday, June 26
2:00–3:15 AM ET The Bee’s Knees of Disease Detection: Swarming the Data with Syndromic Surveillance
5:15–6:00 PM ET Using Near-Real–Time Emergency Department Visit Data for Action

Tuesday, June 27
7:30–8:15 PM ET National Syndromic Surveillance Program Community of Practice Networking Roundtable
12:45–1:30 PM ET Project EMRge: Connecting Public Health and Emergency Medicine
5:15–6:00 PM ET Status and Development Horizon of Analytic Tools in Syndromic Surveillance

Introduction to Syndromic Surveillance (SyS) Methodology

NSSP represents a strategy to integrate near-real–time data with other data sources, connecting healthcare with public health. This training series is designed for new SyS analysts and data consumers to establish foundational concepts of SyS methodology, conceptualize new SyS public health applications, and confidently act on SyS analyses. The series was delivered live in fall 2022 and is now available in an on-demand format on CSTE Learn. NSSP CoP members can access and complete the training for free: create a CSTE Learn account, click “sign up” on home page, register and click “submit.” Once registered, the training can be found here.

SyS State of Mind
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Explore the common data sources and methods that define SyS practice. Learn how analyst query data and craft syndromes for many public health problems. Apply new knowledge to interactive exercises and simulated experiences, preparing learners to look at public health surveillance through a SyS lens.

AnalySyS and Communication
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Translate data into recommendations and public health actions. Learn how to tell a story through SyS analysis interpretation. Simulated learning experiences are coupled with integrated support tools to maximize best practices.

Expanding SyStems
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Identify different SyS analysis methods to support different surveillance and response needs. Learn how to apply a near real-time data source to a diverse set of public health problems, broadening SyS utility. Content for all types of learners, with active engagement, didactic presentations, and action-led micro-learning.

Adult Learning Theory
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Develop trainer skills. Elevate content for effective, formative and meaningful delivery.

Theory Applied- Fishbowl exercise
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Apply adult learning concepts. This exercise supports development and application of trainer skills, fostering a complete learning experience for trainees.

Join the NSSP CoP Slack Workspace
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It’s easy to join. And the community is always exchanging ideas, exploring possibilities, and discussing topics relevant to today’s surveillance challenges.

So what are your colleagues discussing?

  • #analytic-tools
  • #chief-complaint-processing
  • #covid19
  • #data-quality
  • #data-sharing
  • #drug-overdose-use
  • #environmental-health-and-severe-weather
  • #essence-user
  • #general
  • #hospital-admission
  • #lab-data
  • #mortality-data
  • #national-data-requests-sop
  • #nssp-cop
  • #planned-analyses-and-publications
  • #race-and-ethnicity
  • #random
  • #r-user
  • #sas-user
  • #spherr
  • #syndrome-definitions
  • #technical
  • #training
  • #violence-surveillance

Find and Join Channels

  1. Hover cursor over “Channels” on left side of Slack space.
  2. Click the three dots icon that appears next to “Channels” titled “Section Options.”
  3. Select “Browse Channels.”
  4. Find and join any channel that looks interesting!