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Reprinted from Canadian Healthcare Technology, November/December 2012 issue T hough Canadians are healthier and living longer than ever, a number of public health chal- lenges prevail. The leading causes of death among Canadians of all ages include chronic disease and injury. There's also an epidemic number of obese children and adults, an increased rate of asthma and the continued threat of infectious disease. Public health surveillance refers to the systematic collection, analysis and interpre- tation of data on specific health events. It has historically been limited in Canada, particularly when it comes to the study of environmental and social impacts on health. Gaps have also been identified in the surveillance of infectious disease threats, which is essential to anticipat- ing, identifying, monitoring and con- trolling both disease and injury. In response, public health profes- sionals with Kingston, Frontenac and Lennox & Addington (KFL&A) Public Health leveraged Web-based technol- ogy to develop two innovative solu- tions: one that monitors disease out- breaks and provides real-time surveil- lance information to the public and another that serves as a dashboard for cen- tralizing and intersecting environmental health indicators. Tracking the spread of infectious dis- ease: Public health officials need to know when and where infectious disease out- breaks occur so they can actively prevent Canadians from becoming ill. To mitigate the spread of disease, members of the gen- eral public also require access to outbreak information to make informed decisions regarding their own health and well- being. In response, KFL&A Public Health developed an innovative Web mapping application known as Infection WATCH Live that monitors real-time outbreak and disease surveillance in the Kingston, Fron- tenac and Lennox & Addington area. The unique Web map makes Emer- gency Department Syndromic Surveil- lance (EDSS) data from local hospitals available to the public to promote peace of mind while serving as an effective early detection resource. Public health profes- sionals also leverage the app to identify emerging trends that can alert them to potential problems early on. The original EDSS program was creat- ed by adopting an existing tool: the Uni- versity of Pittsburgh's Real-time Outbreak and Disease Surveillance (RODS), which was then modified for public consump- tion. RODS leverages Geographic Infor- mation System (GIS) technology to aggre- gate data and make it publicly available on a map view through the Web. Datasets focus on respiratory and gastrointestinal complaints as these illnesses are rapidly transmitted and pose a significant burden to community health services. Using GIS, respiratory and gastrointesti- nal visit data is evaluated based on season- al, demographic and geographic norms to find trends and predictors for outbreaks. The results are then displayed on a map as areas of high activity in red, elevated activ- ity in yellow and normal activity in green. "The establishment of a surveillance system that uses data from hospital emer- gency departments is invaluable for identi- fying infectious disease risks early on," said Dr. Ian Gemmill, medical officer of health, KFL&A Public Health. Infection WATCH Live now averages over 500 hits per day. The RODS-based sys- tem will soon be substituted with an Acute Care Emergency System (ACES) to provide greater geo-visualization and real-time analytics capabilities. The tool will repro- duce all of the original functionality of RODS and will additionally offer real-time spatial cluster detection so that disease clusters can be rapidly identified and monitored. Integrating public health indica- tors: Environmental determi- nants play a significant but often overlooked role in the health of Canadians, accounting for approximately 16 percent of the total burden of disease. Effective surveillance of environmental health indicators requires the timely exchange of information among laboratories and public health authorities, which can only be accomplished if systems are in place that allow for the capture, integration, analysis and dissemination of data. KFL&A created a Public Health Infor- mation Management System (PHIMS) that provides a centralized, geo-visual dashboard to intersect environmental health indicators with other factors that affect public health. The Web-based dash- board uses GIS technology to present inte- grated data including: current environ- mental conditions, air quality, weather feeds and information from Natural Resources Canada on an interactive map view. The data can be visualized and ana- lyzed to determine potential impacts on health in specific geographic areas. The application is used not only by GIS improves surveillance, helps prepare for public health threats

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