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Report: SIDARTHa Technical Guidelines

1. Fu like DATA SET Urgencias HUMV lt Unrestricted STATIC FILTERS ren Aad gt B gente dem J gt gt MEASURING N mero de Urgencia Gravedad gt B2 Urgente demorabl 1 casos gt DURING THE PERIOD 142 6 Data set 2 Fecha de admisi n Previous 1 days gt ASA N mero de casos x 2011 02 15 109 0 5 FUNCTION OF Urgencia Motivo Consulta gt mi Fix value 89 x 2011 02 15 y 89 0 x Infecci n Tipo Gripe ITG 129 4 A mm cl 3 666 1 3 666 116 2 2 2 4 063 3 4 083 Addiabe ILI 105 0 MEASURE mero de casos Valdecilla has uploaded anew data file 2 22 11 10 27 89 8 Valdecilla has uploaded anew datafile 2 26 11 10 29 Valdecilla has uploaded anew data file 2 27 11 10 25 See all the comments Comment TIME FILTER Fecha de admisi n Previo la i xl Tiempo F 5 30 day ND S 2 Sant Final 62 Technical aspect of Tool Wall Google Chrome m 2 3 12 40 120 Sant Final 1 Sant Final Select benchmarks 24 Technical aspect of Tool El 2 Qu 18 51 SIDARTHa 2010 SIDARTHa Technical Guidelines Tables Tables can be used to do further analyse a specific event i e a day with an alert It is possible to export data as excel or pdf files From the Wall select the database to be used click Analyze and then Tables a table without
2. mediatorsto ensure their maintenance and evolution In this scenario bVh 2 0 enables ways so that users can include the developed componentsin the tool Thus they will have support development and data meanwhile contributing to the same technological upgrading Characteristic s bVh 2 0isa System integration analysis and data mining and the dissemination and knowledge transfer benchmarking among practitioners which supportsthe decison making and research in the health sector Knowledge of business The Network hasbeen developed by and forhealthcare professonals Initially the collaboration with the layers of directors professional and research institutions that currently belong to the Network aimed atacquiring a better understanding of business and allowed usto cut the real needs of all usersin orderto provide an appropriate solution to them Although later we noticed that one of the 0 SIDARTHa 2010 SIDARTHa Technical Guidelines 2 fundamental values of the modelisthat each entity and the add theirown knowledge of business To do this the trees of definition of element definition were generated indicators components data etc so that all knowledge that is contributed by users becomes well organized in the lists through the implementation of algorithmsto manage the same function in terms of use Thus de facto standardsare created in addition to the officials Data processing BVH counts on a user
3. ef Executive Agency for a Health and European Emergency Data based Syndromic Surveillance System Consumers SIDARTHa European Emergency Data based Syndromic Surveillance System Grant Agreement No 2007208 Directorate General for Health amp Consumers SIDARTHa Technical Guidelines How to use the European Emergency Data based Syndromic Surveillance System SIDARTHa SIDARTHa Local Surveillance System Comparison Demand with Daily Threshold Database Automatic Preparation Automatic Baseline amp Threshold Calculation Update Refernce Day Actual Demand Extract jf Report Automatic Ky Data Transfer Automatic Aler Report Support ofLo nition I gency Data m REA DAR THa DataSet Database Query SIDARTHa SIDARTHa Technical Guidelines i SIDARTHa European Emergency Data based Syndromic Surveillance System SIDARTHa European Emergency Data based Syndromic Surveillance System The project European Emergency Data based System for Information on Analysis and Detection of Risks and Threats to Health SIDARTHa is co funded by the European Commission under the Programme of Community Action in the Field of Public Health 2003 2008 Grant Agreement No 2007208 SIDARTHa Steering Committee Luis Garcia Castrillo Riesgo Project Leader Thomas Krafft Scientific Technical Coordinator Matthias
4. Unknown for ID 3 icd the codes according to the ICD specification are stored in this table We are currently using ICD 9 CM as well as ICD 0 3 It has the following columns olumn Area of the specification this code belongs to MORPHOLOGY PROCEDURAL or DIAGNOSTICS It may be Unknown too evel2 level3 severity the severities of the emergencies are stored in this table It has the following columns ID of the severity Use this ID for referencing the centre from other tables You can use the following values SERIOUS MODERATE or Unknown consultationCause the causes that the patients go to emergency for are stored in this table It has the following columns column description ID of the cause Use this ID for referencing the centre from other tables Description of the symptoms the patient has or Unknown SIDARTHa 2010
5. 3 RegH DK 6 SAMU FR SIDARTHa SOA SQL SIDARTHa 2010 SIDARTHa associated partner abbreviation for the University Hospital Antalya Turkey Autoregressive integrated moving average BeValley Health Detection Algorithm used in the Early Aberration Reporting System Cumulative Sum Deliverable No 6 of the SIDARTHa project Data Ware House European Centre for Disease Prevention and Control Emergency Department European Emergency Data European Health Surveillance System in SIDARTHa Emergency Medical Dispatch Emergency Medical Service Extract Transfer Load European Union Frequently Asked Questions SIDARTHa associated partner abbreviation for the federal public service health food chain safety and environment Belgium SIDARTHa associated partner abbreviation for the GEOMED Research Forschungsgesellschaft mbH Germany Geographic Information System SIDARTHa associated partner abbreviation for the San Martino University Hospital Genoa Italy SIDARTHa associated partner abbreviation for the Haukeland University Hospital Bergen Norway International Classification of Diseases Influenza Like IlIness Information Technology SIDARTHa associated partner abbreviation for the Klinik am Eichert Clinics of the County of Goeppingen Germany SIDARTHa associated partner abbreviation for the University Hospital Kuopio Finland Local Health Surveillance System in SIDARTHa SIDARTHa associated partner abbreviation for the Dis
6. 49 2224 7799897 mail sidartha eu www sidartha eu 0 SIDARTHa 2010 SIDARTHa Technical Guidelines Contents CONTENTS Z Su uy t TETTE Il FIGURE Sages sey a A IV L uu ua am us s D V ERE MIP w INTRODUGCIONSIHESIDARIHAPRO LCD 1 2 DDJECINESSMEIHODO0L00Y uu m 3 2 1 DBIECHVBS Cd dt 3 2 2 METHODOLOGY 3 3 SIDARTHA SYNDROMIC SURVEILLANCE SYSTEM DESIGN ERE OR Fe Na Eme 5 3 1 STATE OF THE ART SYNDROMIC SURVEILLANCE SYSTEM DESIGN enn 5 3 2 SIDARTHA SYNDROMIC SUR VEILLANCE SYSTEM DESIGN enn 6 3 3 SIDARTHA SYNDROMIC SUR VEILLANCE APPLICATION se eee 9 3 4 FUTURE USER REQUIREMENT S siete tei m 9 TECHNICAL OUIDEBINES a a a a 10 4 1 DEMO VERSION amp SUPPORT ace dec 10 4 2 DOWNLOAD ae caen ee sQ 11 4 2 USER MANUAL ee 13 JT 25 bSIDARTHAEOCALHEAETHSSURVEILEANGE SYSTEM u u u u u S 13 42528 EUROPEAN HEAETH SURVEILLANCE SYSTEM ETS uuu 77777 18 R F RENCES 19 APPEND ae 20 APPENDIX 1 SIDARTHA SHORT SURVEY ON USER REQUIREMENTS e
7. EU Early oem Alerting pee Systems Regional Regional Automatic Data National Health National Health Processing Analysis Authority Authority Automatic Data Transfer Automatic Alert Report Manual Alert Report __ Local Health Local Health Communication Authority Authority Support Syndromic Syndromic Syndromic Surveillance Surveillance Surveillance Application Application Application Syndromic Syndromic Surveillance Surveillance Application Application Hospital EMS Dispatch Region A Region A Region A Hospital EMS Region B Region B Figure 4 SIDARTHa Syndromic Surveillance System Design Version 2 EMS Emergency Medical Service EU European Union Regional Health autor SIDARTHa Syndromic Surveillance Application Alert Standardised Report Comparison Demand with Daily Threshold D Interactive Display aa lt gt reparatio Actual Demand Baseline amp Threshold Extract Calculation Update Refernce Day Report Display Automatic EMS gt Data Transfer RegionA Automatic Alert Report Communication Support Translation of Local Manual Database Emergency Data Into Derinition EMS SIDARTHa DataSet SIDARTHa Region Database Query Data Set Figure 5 SIDARTHa Syndromic Surveillance System Design Regional Level Version 2 EMS Emergency Medical Service SIDARTHa 2010 SIDARTHa Technical Guide
8. Latitude of the postal code location used for GIS analyses or NULL for Unknown Longitude of the postal code location used for GIS analyses or NULL for Unknown dayOfWeek the days of the week are stored in this table It has the following columns ID of the day of week Use this ID for referencing the centre from other tables dayOfWeek Name for the day of week in your language Friday vendredi viernes It may be Unknown too Ordinal for the day in the week Use 1 for Sunday 2 for Monday 7 for Saturday NULL for Unknown the ages of the patients stored in this table It has the following columns ID of the age Use this ID for referencing the centre from other tables ageGroup Group this age belongs to You can use these groups Less than 5 5 14 15 29 30 44 45 59 60 74 75 89 90 or more Unknown ageGroupOrdinal Ordinal for the age group Use 0 for Less than 5 1 for 5 14 7 for 90 or more NULL for Unknown age itself or Unknown ageOrdinal Ordinal for the age Use the age number except NULL for Unknown 0 SIDARTHa 2010 SIDARTHa Technical Guidelines 33 date the dates of the emergencies are stored in this table It has the following columns ID of the date Use this ID for referencing the centre from other tables The year or Unknown The quarter In the current ver
9. Fischer Alexander Kramer Freddy Lippert Gernot Vergeiner SIDARTHa Project Group Dispatch Centre Tyrol Austria contact person Gernot Vergeiner Federal Government Department of Public Health Belgium contact person Agnes Meulemans Emergency Medical Service Prague Czech Republic contact person Milana Pokorna Capital Region Denmark contact person Freddy Lippert University Hospital Kuopio Finland contact person Jouni Kurola Emergency Medical Service Province Hauts de Seine France contact person Michel Baer Hospitals of County of Goeppingen Germany contact person Matthias Fischer GEOMED Research Forschungsgesellschaft mbH Germany contact person Thomas Krafft University of Bielefeld Department of Public Health Medicine Germany contact person Alexander Kramer National Emergency Medical Service Hungary contact person Gabor 6001 Maastricht University Department of International Health contact person Helmut Brand Netherlands San Martino University Hospital Genoa Italy contact person Francesco Bermano Haukeland University Hospital Bergen Norway contact person Guttorm Brattebo University of Cantabria Spain contact person Luis Garcia Castrillo Riesgo University Hospital Antalya Turkey contact person Hakan Yaman Advisory Board Helmut Brand The Netherlands Chair Andrea Ammon ECDC Enrico Davoli WHO Euro Per Kulling 2008 2009 amp Franz Karcher 2009 2010 EU Health Threat Uni
10. Other bookmarks A SIDARTHA Luis Garcia Castillo Followers Who to follow Most used data sets 15 Select Benchmark to change the detection algorithm and change the alert threshold Accept the selection Any combination of detection algorithms can be chosen One can set limits for one algorithm and chose another as benchmark e g CUSUM as upper limit and CI C2 C3 as benchmark It always has to be defined if high or low values generate the alert A wide range of thresholds can be selected Fixed values Benchmark with historical data Prediction benchmark with a selection of algorithms SIDARTHa Technical Guidelines 16 Ifa data set with a high number of cases over a longer period Save the newly defined indicator by clicking Save and exit 5 analysed 1 total number of cases it is recommended to use algorithms that take into consideration seasonal variation Modifications can be done to any of the components later on if enough historical data is available such as ARIMA Struct Choose Discard if you do not want to save the indicator Ts or Holt Winters Once the indicator has been saved it is updated automatically For smaller or more specific data sets e g syndromes it is In the box below the figure the last updates are stated recommended to use CUSUM or C1 C2 C3 Ca 9 9 Technical aspect of Tool evaluation Microsoft Word 2 5 Select benchmar
11. any filter or specification is generated As for graphs maps and indicators static filters temporal filters and measures can be defined Over the table the defined characteristics are displayed Before you leave the screen save the table by clicking Save and exit Modifications can be done to any of the components later Click Discard if the table should not be saved syl ys C https www bevalley com isf table view seam conversationld 23552 Ya https www bevalley com jisf table view seam conversationId 23552 w Hotmail gratuto Personal ete hoe ke helene USES E Hotmail gratuito 7 Personal lizar v nculos 7 Windows Media Windows 7 StoCon Pul svenska Other bookmarks SIDARTHA Luis Garcia Castillo o SIDARTHA Luis Garcia Castrillo gt d LIA B valle roe wenspu tage Static filters Temporal filters Measures Variables Export as excel 1 Save and exit Discard Editing temporal filter SIRO APR Neen cites Ditonrd element Data updated to date 2 27 10 25 STATIC FILTERS STATIC FILTERS Jrgenci iveda Bl Urgente TEMPORAL FILTERS rr Fecha de admision Previo TEMPORAL FILTERS Desconocido 0 14 15 29 30 44 45 59 60 74 75 89 gt 90 1 INVITATIONS AVAILABLE ISSUES AND SUGGESTIONS ENTITIES FAQ LEGAL DEVELOPERS MODE 1 INVITATIONS A
12. can be a community city county district or state The implementation of the SIDARTHa syndromic surveillance system can be based on data collected for the same administrative level or also for a part of this area or based on the catchment areas of one or more participating emergency institutions SIDARTHa Technical Guidelines PHASE I Conceptualisation PHASE II Implementation Implemen tation gt gt D ART Ha Evaluation Project Coordination Dissemination of Project Results Project Evaluation amp 8185148 amp 5 8 amp 8 Figure 1 SIDARTHa Project Methodology M Month of the project time O BBQ Pres B ROUTINE DATA a lt REPORT ALERT ROUTINE DATA REPORT ALERT Routine data from i emergency SIDARTHa alerts emergency professionals and regional public medical dispatch centres ii health authorities if a threshold is exceeded ambulance patient documentations Via national authorities the European Commission ECDC and and iii emergency department WHO can be informed about regional and cross border alerts SIDARTHa can be used for risk communication about the event SIDARTHa information systems is analysed for spatial and temporal abberations at the SIDARTHa only complements regional level but does not replace any existing system Figure 2 SIDARTHa Approach ECDC European Centre for Disease Prevention and Control WHO W
13. of an organization Lack of technological systemswith potential to support benchmarking health networks of global level Lackoftechnological sytemsthat allow the performance of benchmarking health from the raw data from operational sources of health institutions Today Benchmarking networks work without technological support and from the aggregated indicators previously calculated they are not reliable in comparison process Lack of technological sytemsthat can support the construction of technological components forthird parties with guaranteed support and accommodation using a central repository of health information and accessto specific functions of business intelligence including data mining and artificial intelligence Lack of flexible technological sytemsthat can generate public health alarms from the routine operational sourcesand health institutions ala ms synd romic e Absence of a segmented platform scientific and objective where healthcare providers especially pharmacists can advertise their prescription drugsand replace theircommercial health vistors Absence of a platfom that allows predictive models and hidden pattems searches from data stored one central repository of health information systems using data mining and Artificial Intelligence Absence of a technological tool that claimsto be a viewerof single electronic medical record globally There isa need fora global platform wit
14. source software the web interface incorporates tools for decision support research promotion social networking and benchmarking The platform has been developed following a service oriented architecture SOA deployed on JBoss AS as application 2EE server Furthermore it has provided a portal to a dynamic interface using JBoss RichFaces which allows AJAX and JSF technology to be integrated The automated detection algorithms were constructed to calculate the alarm limits in R language of R Project Algorithms included in the initial version are Holt Winters Smoothing CUSUM for normal and Poisson distributed data StructTS AR and CI 2 C3 Figure 6 provides an overview on the technical architecture of the SIDARTHa application 9 B 1 fuente 2 s 120 fuente 3 S Vs SIDARTHa Technical Guidelines 34 Future User Requirements The 43 interviewees were mainly working in the areas of public health practice public health science and epidemiology statistics One third of the respondents have experience syndromic surveillance using it mainly in public health practice science and during special events mass gatherings not in health care practice or decision making The experienced interviewees chose a broad range of important characteristics of syndromic surveillance the top three being usefullnes during special events timeliness between event and reporting and compared to traditional surveillance and
15. using indicators derived from routinely collected emergency medical services prehospital and emergency department hospital data The SIDARTHa syndromic surveillance system targets at the local regional level and does not replace any existing surveillance structures Survey Purpose Assessment of requirements and needs for syndromic surveillance in Europe Your replies in this survey will directly be incorporated in the design of the SIDARTHa syndromic surveillance system The SIDARTHa syndromic surveillance software application will be available for implementation across Europe free of charge after the project time Definition Syndromic surveillance is understood in this survey as an investigational approach where health department staff assisted by automated data acquisition and generation of Statistical signals monitor disease indicators continually real time or at least daily near real time to detect outbreaks of diseases earlier and more completely than might otherwise be possible with traditional public health methods e g by reportable disease surveillance and telephone consultation We very much appreciate your support in completing and returning this survey to the SIDARTHa team Thank you very much YOUR ROLE 1 am mainly involved 1 1 1 O public health 121 O scientifically 1 1 2 O health care 1 22 O professionally 1 1 3 epidemiology statistics 1 23 O politically 1 1 4 other 2 1 mainly wor
16. AV allowed the developed prototypesto be stuated at the forefront of the state of the art technology allowing solving big limitations in which health professonals meet in their processof adaptation to the information society E Diffic ulties with ma nagement oriented operation to determine the quality and usefulness of huge amounts and dispersed data 0 SIDARTHa 2010 SIDARTHa Technical Guidelines 26 Proliferation of many Business Intelligence technological tools to be selected and combined to obtain a reliable operation of the data systems Balanced Scorecard GIS geographic representation reporting systems OLAP systems among others e Limited accessto information associated with the high costsof available technology marketed by userlicenses Lack of standardization at all levels data layer businesslayer etc FEASIBILITY STUDY 2 Preparatory to expenmental development for the construction of bVh 2 0 At this point we find that there are number of needsthat motivate a feasibility study preparatory forthe expenmental development of a prototype prototype BVH 2 0 that enables decisions making ina framework where users enter their own data define theirtrees elements indic ators etc exchange their knowledge of businessand may accessto the function of the permissions according to the exploitation of all available data in the sytem We consderate that thisis an extraordinary project which in its operation ensuresth
17. DARTHa 2010 10 a Gevalleu networ Upload new data set BRST Ni EN etat Castrillo People My elements Public data All Ba Analyze Remove Share Make public Following Followers Who to follow Delete Share Make public SIDARTHa Technical Guidelines Analysis Indicator generation This function allows you to create indicators for specific syndromes set alerts and generate graphs tables or maps Clicking on Analyze in the box of a data base a Selection of analyses are presented Graphs tables indicators indicator with predictive analysis and map representation After having chosen the analysis option the characteristics are defined in the next step static filter e g specific syndrome measure e g number of cases time filter e g today benchmark detection algorithm and alert threshold lt B https www bevalley com jsf board board seam searchHType WALL amp conversationId 13000 E Hotmail gratuito Personalizar v nculos 7 Windows Media 7 Windows 7 StoCon Pul svenska Profile messages Log out Last update Up Time graph Evaluation EX YI RESTRICTIONS SHARED BY Indicator Prediction indicator a Represent data with line or bar graphs or pie charts Represent the evolution in time of one or more variables and compare them with other periods The date which the analysis is regar
18. Description gt A management oflndependent dimenson time gt Incormoration of obligatory filters gt Incorporation of targets and referencesto previousperiods Date 01 01 2010 Version 2010 01 codename Perezgil Desc ription gt management of Independent dimenson entity gt Incorporation of functionalities forthe relationship between entities gt Implementation of the benchmarking system Date 01 02 2010 Version 2010 02 codename Conde Draco Desc ription Transformation of analysis network into a complete SOCIAL NETWO RK analysis and comparison Date 01 03 2010 Versio 2010 03 codename Sheriff Coco Descripci n The completion of the API for the integration of the third party applications SIDARTHa 2010 SIDARTHa Technical Guidelines 32 Appendix 3 SIDARTHa Application Setup Data base contents emergency every emergency should be reflected with exactly one record in this table It has the following columns column description ld ID of the emergency It is marked as auto increment so you should leave it blank when inserting the record Centre the medical centres are stored in this table It has the following columns description postalCode the postal codes of the patients are stored in this table It has the following columns description ID of the postal code Use this ID for referencing the centre from other tables postalCode The postal code itself or Unknown
19. VAILABLE ISSUES AND SUGGESTIONS ENTITIES FAQ LEGAL DEVELOPERS MODE A 1nicio L3 Sant Final Technical aspect of Tool Table Google Chrome Es lt 2 3 2 Mh 12 51 A Inicio 2 Sant Final Technical aspect of Tool P Table Google Chrome Es a 13 02 Maps In this version of the SIDARTHa application Google Maps is used to represent the spatial distribution of cases in absolute numbers if spatial information is included in the uploaded data base SIDARTHa 2010 17 SIDARTHa Technical Guidelines 4 2 2 SIDARTHa European Health Surveillance System EHSS The SIDARTHa application 15 designed to facilitate exchange between different users of the system The extent to which results or data are exchanged 15 decided by the owner of the information Information databases graphs tables or indicators can be shared to any other registered user of the SIDARTHa application There are two levels of sharing information the public or specific users To share information Share can be selected in the respective box of one indicator or data base A new window with a search tool allows you to choose the registered user to share the information with General demand V er 2 F Paulo Pinheiro 1 2 4 juan paulo cid Valdecilla has ur b ULM Valdecilla ploaded b UM Valdecilla has up See all t
20. bevalley com SIDARTHa module http download bevalley com sidartha Download and installation needs some IT expertise BeValley Technologies group provides support on this process to future users The following setup instructions by BeValley Technologies are targeted at IT personal in the emergency institutions First you will have to download Boss AS Currently we are using version 5 1 0 GA although any higher version should work as well Here is the download link http sourceforge net projects jboss files Boss Boss 5 1 0 6A jboss 5 1 0 GA jdk6 zip download As the file name suggests you will need a DK 6 environment Instructions on how to install and configure the server can be found in the JBoss Community page You will also need a MySQL 5 database server Create a user named bit with password bit and grant it with rights for databases bit and dwh Populate the bit and dwh databases with the following SQL scripts BIT gt bitsal DWH gt dwh sal The last step is deploying the application into the running server Download every file and copy it to the server default deploy directory in the JBoss AS installation BIT data source gt bit mysql ds xml DWH data source gt dwh mysql xa ds xml BeValley health application gt health bit application 2010 02 1 ear md5sum ba467c317cd56eb780bfa4a966dc8a11 There are ten predefined users super who has access to all data and another nine ranging
21. c ription UserInterface oriented technology division Bloc ks analysis of hospitalization data validated by the users of the living lab Hospitalization episodes sub episodesof service waiting lists visit sessions Surgical interventions interventions waiting lists surgic al sessions Diagnostic techniques techniques waiting lists technical sessions Emergencies Primary care episodes Primary care pharmaceutical prescription Primary care immunizations Technology modules o analysis First stable version o Control panel system and indicatorgeneration from OLAP First stable version o GISAnalyss first table version based on MapXtreme SIDARTHa 2010 SIDARTHa Technical Guidelines 31 Date 01 06 2009 Version 2009 06 codename Caponata COMPLETE Description gt UserInterface onented to end users gt The same blocks of data analyss with the primary care data through living la b users gt Technology modules e Ability to export recordsto SPSS from searches made with the OLAP system Incorporation of PHPMyAdmin to analyze the Operational Data Warehouse Date 03 07 2009 Version 2009 07 codename Nabucodonosorcito COMPLETE Desc ription Ability to generate reportsfrom the leavesand the views of users A support for OLAP query generation A support for Geographic Information Systems GIS generation Date 21 09 2009 Version 2009 09 codename J uan Olvido COMPLETE
22. d data set using the function Management of data set Successfully uploaded data sets are accessible from the Wall Using Data For an uploaded data base several actions can be chose pata Network Googl 2 Sent Final e Make Public Or one can click on the database to change its name or access the option Management of data set Another option 15 to let the database become part of a group using Add a label Labels facilitate navigation by grouping diferent elements data bases indicators graphs or maps under one label Analyze The labels can be selected from the Wal in the green box on the right e Share e Delete y 6 wa WES x amp 8 https www bevalley com jsf board board seam searchiType WALL amp conversationild 130004 Hotmail gratuito Personalizar v nculos Windows Media Windows StoCon Pul svenska Other bookmarks SIDARTHA Luis Garcia Castillo Profile messages Log out Update your status Last update Update yourstatus updated 2 days ago Update Evaluation EX votes RESTRICTIONS SHARED BY 5 Add label Comment Casos Diarios YrYrYrYrYy votes DATA SET Urgencias HUMV lt Unrestricted gt gt MEASURING Numero de casos gt WITH RESPECT TO Tiempo Fecha de admisi n https bevalley com jsf board board seam searchType WALL amp conversationiId 3000 FR TI EHE 0 SI
23. ding to reference date can be modified Represent data in tables which makes it possible to go deeper until reach the original data Besides data can be exported to different formats Represent the curen value for measure reference date can be modified You can set comparison valves based on other periods or fixed benchmarks Can generate alamns to represent the valve of the previous day compared with predicted valves for that day and the application of statistical margin of error DATA SET gt M MEASURING gt WITH RESPECT TO Inicio 11 Skype 2 lgcast 2 wall Google Chrome Sant Final i9 Technical aspect of Tool Indicator Generation Two types of indicators are offered general indicators with basic analytical information means sum etc and predictive indicators The latter are useful to compare predicted with actual values and set thresholds for alerts At the Indicator screen select Static Filter and chose the variables that generate the desired syndrome Select an individual variable or a combination of multiple variables that defines the desired syndrome in the left green window Accept the selection Select Measure for different values e g number of cases rows Accept the selection For the Time filter the previous day is set by default but specific dates and time periods can be chosen Accept the selection SIDARTHa 2010 valley 81 x
24. e admisi n x 116 3 INEI StructTS 2 213 023 raised a 64 5 CUS MEASURE HoltWinters lumero de caso 2 233 52 7 foo 1 20 9 Previous 1 day 4 024 e gt 1 c3 4 083 TIME FILTER Tiempo Fecha de adrnisi n P J Previous 368 day zi QT ues casera B select benchmarks n Tea aspect To P Skype 2 Igcast Select benchmarks L Sant Final E Technical aspect of Tool 52 Microsoft Excel Santan A Inicio y5 Wall E Select benchmarks exti 22 B https www bevalley com jsf board board seam searchType WALL amp conversationId 22669 wit B https www bevalley com isf graph view seam conversationiId 27665 wit E Hotmail gratuito Personalizar vinculos WindowsMedia 1 Windows 7 StoCon Pul svenska Other bookmarks Y Hotmail gratuito Personalizar v nculos Windows Media Windows StoCon Pul svenska C2 Other bookmarks SIDARTHA Luis Garc a Castillo beta m Profile messages Log out e Labels Delete Share Make public General network J Gastrointestinal _ Respiratorio Static filters Measure Time filler Benchmarks Save exit Discard wayyy votes F Data updated to date 2 27 11 10 25
25. e Maps system management operational database phpMyAdmin and OS Ubuntu Linux Implementation The criteria of value when implementing the model has been the guarantee of accessibility to all users managers researchers and practitioners without restriction of space time To do this it hasresorted to the use of accessible technologies via web WOA While each entity that is wished can have the software installed on their own servers State of the art 2 0 BVH largely exceedsthe current state of the art State ofthe art 1 e Lack of technological tools which are capable of exploiting the big amount of existing health data eitherby the lack of technological capabilities orla ck of functionality required fortheir orientation to the field of health management research or health sciences e Lack of integrated technology toolsto identify and correct for semi automatically by data mining systems the quality of different sources Lack of Open Source technology tools for integration with busness knowledge of health coding data dictionanes etc included Proliferation of many technological tools Bl Business Intelligence Open Source disointed to be selected and combined to obtain a reliable operation of the data systems Balanced Scorecard GISgeographic representation Reporting systems systems among others 0 SIDARTHa 2010 SIDARTHa Technical Guidelines 28 Lack of technological tools that give users unl
26. e accessibility of all professionals doctors researchers managers etc to information and enablesan environment in which users themselves evolve the model based on specific needs Moreover the prototype has been developed in the environment of a living lab in which users would have shown that the factors influencing the same In particular the needsthat have led usto evolve the model were Lack of standardization of criteria fordefining the indicators of an organization or professional which on the otherhand complicates infomation sharing and public health benchmarking is difficult to cary out Moreover it offersthe opportunity to propose a unique space for disc usson the exchange of information and data forall public health professionals So farthe professionals who are involved in benchmarking networks improve their decison making processes by providing aggregated data that may have been estimated with different criteria and therefore would not be reliable in the comparative process In this context it becomesapparent the usefulness of collecting the raw data and then homogenize the technological tool to offereach professonal the information in demand foreach respondent according to the indicatorsthat they themselvesdefine in an authorized interface forthis purpose There are many working groups both management research that develop technology projectsthat normally they are not used forlack of data orbecaus there
27. e has to be named sidartha xml and has to be placed in a directory called etc in the root of the same file system where you have installed JBoss AS You can see the flle format in Figure 8 The first three parameters of each SIDARTHa indicator make reference to the user that created the indicator that has to be updated the dashboard le tab where the indicator is located and the name of the indicator The only requisite is that the time filter for the indicator is From the start of day the prediction is estimated using aggregates for day periods SIDARTHa Technical Guidelines 12 so any other time filter will lead to an erroneous prediction However the indicator may have any other additional filter gender department that will be taken into account for calculations thus providing a great flexibility Then you can optionally add a warning element a critical element and as many benchmark elements as you want but in this order The value of any of these elements is the algorithm used for predicition Valid values are Ho tWinters StructTS AR ARIMA CUSUM and C1 C2 C3 For the prediction we use the values of the last 250 weeks 1750 days not including today This parameter will be configurable in future releases VERY IMPORTANT please make sure that you populate the date table with values for all these days even if there are no corresponding facts This is the only way to tell the analysis tool that the aggregate for t
28. e including an overview on contacts and indicator groups right Upload of new data top 4 wall lt Rr Hotmail gratuito https www bevalley com jsf board board seam searchType V Es Personalizar v nculos 1 Windows Media 7 Windows profile y messages 2 1 aul Last update Update yourstatus Update Toxic 6 5 2 Numero de casos y DATA SET Ur mme be Consulta gt o o e gt asua Valdecilla has uploaded anew datafile 3 25 StoCon Pul svenska LITT Wall People My elements Public data gt gt M MEASURING N de casos gt DURING THE PERIOD dmi n Fecha days gt FILTERED BY encia Motivo Add label 13 Search machine top centre All data bases and analyses left Message board top left Help and FAQ bottom The user profile shows contacts databases and indicator groups labels covering e g all analyses related to a certain data source The left central area contains all data bases indicators tables graphs generated by the user or shared by other users Each item is displayed in a box containing also further information or comments x Other bookmarks 5evalleu onversationId 74956 Upload new data set SIDARTHA Luis Garcia Castrillo 2 All Delete Share Make public Following 0 Followers 0 Who to fall
29. eing based in emerergency care institutions SIDARTHa has the potential to be used for decision making and managing resources in these institutions as well The results of the survey also show the need to advertise the use of syndromic surveillance and provide knowledge and good practice experiences from experienced syndromic surveillance users to those not yet experienced The SIDARTHa project will publish all results and provides its syndromic surveillance application free of charge it will provide handbooks and recommendations for users of SIDARTHa to foster the acceptance of the system Why don t you use syndromic surveillance percentage of all answers 95 Syndromic Surveillance in Europe Needed 100 Figure 7 SIDARTHa short survey results 0 SIDARTHa 2010 SIDARTHa Technical Guidelines 4 Technical Guidelines 4 1 Demo Version amp Support The SIDARTHa syndromic surveillance application is also available as demo version in order to be tested by potential future users before installing the software in their own institutions The demo version uses artificial data and displays predefined analyses to show the design and functions of the software The demo version 15 accessible online and must not be downloaded It can be accessed through the SIDARTHa website www sidartha eu surveillancesystem demo htm To use the demo version the user has to register with BeValley Technol
30. ent e g daily 7 3 OI would automatically receive standardised short reports by email fax etc on an event 74 OI would want to actively analyse the syndromic surveillance data including historical events 7 5 Lll would include a virtual platform for communication of all stakeholders during an event 7 6 O1would include a cross region or cross border analysis of events 77 OI would enhance collaboration between public health health care provision and non health stakeholders 7 8 FINALLY 8 Syndromic Surveillance in Europe is needed L not needed 9 am 10 My age is 10 1 O lt 25 10 2 O 25 40 mec 10 3 041 65 104 gt 65 SIDARTHa Project Survey Syndromic Surveillance in Europe 3 SIDARTHa 2010 SIDARTHa Technical Guidelines 25 Appendix 2 Technical Development of BeValley Health Project background We want you to know where this initiative comes from and how it hasbeen developing to the current situation in which we will show it to you Starting point EXPERIMENTAL DEVELO PMENT IN THE AREA OF SURGICAL INTERVENSIONS Asa starting point it conductsan expenmental development project involving the construction of a prototype of a technological tool prototype QUIVER created forthe analysis and exploitation of the surgical data which was funded by be Valley Technologies in collaboration with the Society Cantabna Regional Development Sodercan through Invesnova plan The project was imp
31. ent to traditional surveillance Usefulness for surveillance of seasonal outbreaks O Usefulness for surveillance for detecting known or unknown public health threats Usefulness for surveillance during special events mass gatherings natural disasters Close collaboration between public health and health care provision other SIDARTHa Project Survey Syndromic Surveillance in Europe SIDARTHa 2010 23 SIDARTHa Technical Guidelines 24 2nd European Public Health Conference 27 November 2009 IF NO 6 do not use syndromic surveillance because please tick up to five boxes 6 1 no applicable concept is available in the European context 62 Othe usefulness of syndromic surveillance is not proven for the European context 63 Ono additional value is expected compared to existing surveillance structures 64 Ono data suitable for syndromic surveillance are collected 65 Ono collaboration exists with providers of suitable data 6 6 expertise knowledge for setup maintenance is missing 6 7 O technical infrastructure is missing 6 8 O additional workload costs are produced 6 9 Oto many false alerts are produced 6 10 O other DESIGN OF SYNDROMIC SURVEILLANCE SYSTEMS 7 If you were developing the optimal syndromic surveillance system please tick up to five boxes 7 1 L1I would only be informed about the detection of an event 7 2 TOI would be informed regularly independent of detection of an ev
32. formaintenance and data availability Economic benefits POINTER SYSTEM OF R amp D Isa great innovation because it isbased onthe construction of a single technological solution Open Source without licenses orunits available formany entities and users and also developsand deploys technologies applications services and content of the Society of Information and the future intemet POSITIONING ON THE INTERNET OF THE FUTURE bVh integrates the intemet for people services and content encouraging the development of the information society and knowledge and allowing usto be equipped with most developed countnesin this field In the system the users themselves who generate content and make the model evolved according to their request Furthermore it evolvesand improves collaborative work creating a virtual community On the other hand isintegrated in the field of Intemet services with a platform Web Oriented Architecture RESPO NSIBLE FOR THE DEVELOPMENT TEC HNOLOGY SECTOR The projects aimsto change the way we use the technology to exploit the information in the health sector from a traditional model in which each entity implants and uses various technological toolsto a frameworkthat provides a unique technological tool forinfinite users We furtherbelieve that technological developments ensures the health sector because first it brings the future intemet closer to thisfield and on the otherhand being based on Open Source technolog
33. from userl to user9 who won t be able to see anything until super or another user creates a profile for them All passwords are equal to the login 0 SIDARTHa 2010 There aren t any health data so you will have to load it into the dwh database Here is a brief explanation of the tables for the ED context the detailed tables can be found in Appendix 3 emergency every emergency should be reflected with exactly one record Centre the medical centres are stored in this table postalCode the postal codes of the patients are stored in this table dayOfWeek the days of the week are stored in this table age the ages of the patients are stored in this table date the dates of the emergencies are stored in this table time the times of the emergencies are stored in this table department the departments of the hospital or EMS are stored in this table gender the gender of the emergencies are stored in this table cd the codes according to the ICD specification are Stored in this table We are currently using ICD 9 CM as well as ICD 0 3 severity the severities of the emergencies are stored in this table Consultation Cause the reasons for demanding care stored this table The integration of SIDARTHa is accomplished through an XML configuration file You can update any indicator you have previously created with predictions based on previous values The configuration fil
34. h clinical data and tools foc used the investigation SIDARTHa 2010 SIDARTHa Technical Guidelines 29 Advantages bVh 2 0 allowsto have a real Health Observatory Key features BVH 2 0 integrates and homogenizesthe data using available technology to facilitate their exploitation It involves the introduction of an exploitation culture and increas the profitability of the Information in the health sector which contnbutesto the shift to organizational excellence and that each person can have the information anytime they need Thus it will encourage accessto better health It also promotesthe sharing of waysto exploit the information formanagement and research Advancesto the democratization of information ensuring accessof any userof an organization layer directive professonal layer layer research to any data e g any professional can now have theirown scorecard e to ensure the support of decision making based on objective data allowing the reduction of waiting lists migration assistance etc and encouraging the making of comparisons in traditionally opaque sector benchmarking among professionals to introduce future intemet in the health sectorby enabling a space that evolves thanks to the userswho ensure their suita bility to the specific needsof the sector to allow to give support to multitude technology projects that in otherwordswould not evolve because ofthe lack of resources
35. hat day has been zero The update process is intended to be executed periodically according to a configurable schedule but for this first implementation you will have to update the indicators manually Please use the following URL htto server 8080 health bit sidartha in which server is the host name of the server where bVh is installed lt xml version 1 0 encoding UTF 8 gt lt sidartha xmlns http health bevalley com sidartha xmlns xsi http www w3 org 2001 XMLSchema instance xSi schemaLocation http health bevalley com sidartha sidartha xsd gt sidartha indicator user user2 user dashboard Panel 1 dashboard lt indicator gt sidartha test lt indicator gt lt warning gt ar lt warning gt lt lt benchmark gt arima lt benchmark gt lt sidartha indicator gt lt sidartha indicator gt lt user gt userl lt user gt lt dashboard gt Panel 2 lt dashboard gt lt indicator gt sidartha test lt indicator gt lt Crivthacaloarima lt Critical gt lt benchmark gt c123 lt benchmark gt lt benchmark gt HoltWinters lt benchmark gt lt sidartha indicator gt lt sidartha gt Figure 8 SIDARTHa application file format SIDARTHa 2010 SIDARTHa Technical Guidelines 4 2 User Manual 421 SIDARTHa Local Health Surveillance System LHSS The Wall After login in the tool provides different options from the main page or the Wall User profil
36. he comments as CA UIET es QUE UONE yua CIC dse ar Static filters Measure Time filler Benchmarks Save and exit Discard Make public Data updated to date STATIC FILTERS MEASURE 519 0 4 18 When clicking on an indicator the list of persons this indicator has been shared with appears on the right green information box Here sharing of this indicator can be disabled for a selected user When sharing an indicator table or map the user can only see it When a data base is shared the other user can analyse the data and generate new indicators When choosing Make public the indicator or data base is shared with any member of the BeValley Network beyond the SIDARTHa network Users are informed when information was shared with them the message board Access to messages 15 possible the Wal Cancel v COI IU para sio 7 es General demand bouis des Updated Data set Shared with 2 r1 Alexandra Ziemann x FA MANUEL GALAN CUESTA x r1 Santiago Rodriguez TIME FILTER 0 SIDARTHa 2010 Cantabria SIDARTHa Technical Guidelines 19 References 1 Ziemann A Krafft Garcia Castrillo Riesgo Fischer M Kramer A Lippert Vergeiner G for the SIDARTHa project group eds Early Detection of Health Threats International State of the Art amp European Conte
37. ies the progress will be in parallel with the evolution in orderto be happened foreach of these applications that are useful to the technological tool that will support the project 0 SIDARTHa 2010 SIDARTHa Technical Guidelines 30 TO DEVELOP AND TO IMPROVE MPETITIVENESS AND PROHTABILITY IN THE HELD It favorsthe increase of competitiveness introducing a new model where there isa progressin which the administrator becomes a client and productivity in the health sector allowing research management approaching the scoreboard from one organization to all levels of users encouraging benchmarking processes etc Besides it improvesthe innovation and creativity in organizations promoting the development of managerial skills for decision making Promotes scientific research HEALTH It promotes scientific research in the health sectorand especially translational research which in case of sharing the data and knowledge of business not only promotes research but also its application to a clinical practice updating and exploitation of investigation results To drive democratization in accessto infomation It promotes democratization of data favoring the equality in ac cessto information aswell as intensifying and generalizing the use of ICTin the primary sector health orsecondary consulting etc in which the project act a de modo tractor Roadmap Date 01 05 2009 Version 2009 05 Codename Espinete C OMPLETE Des
38. imited accessto exploitation All existing solutions are architecturally designed to provide support to decision making to a low number of users layer directive Absent in open source word of certain essential components forthe exploitation of information in healthcare both asa management onented research so there isa associated limit of the high costs of available technology marketed by licensing user Lack of standardization at all levels data layer businesslayer etc These points were exceeded with the first prototype to be Valley health BVH Prototype Subsequently it was found that a number of needs that motivate the development of an improved system BVH 2 0 fortaking decisonswithin a framework where the usersentertheirdata have a central repository of information exchange knowledge of business and could access depending on permissions the exploitation of all available data Regarding the state of art noting that is still applicable today that isto rise to 2 0 BVH as faraspossble State of the art 11 E Lack of technological systems thanks to architectural design are capable of addressing issues of confidentiality of health authorities Lack of technological sytemsforthe homogenization of criteria defining health indicators at individual or organizational Lack of technological systems oriented health information exchange and business knowledge and management of health at all users
39. interface to ensure the automatic collection of data for each entity which was provided by ETL processes extraction transformation and loading of data Thisinterface hasbeen built based on knowledge of the sourcesthat give usthe experience of living lab Though it isopen to every entity the users could suggest new fieldsfordata which are not contemplated and that similarly might be interesting Furthermore the data collected alwaysraw data so thatthey can be exploited to the indicators defined by each user Once they are incorporated into the data to BVH they are stored in the Data Warehouse DWH which in tum will be divided into two operational DWH fueled by the raw data DWH of analysis on which it perform the exploitation of data with tools of the system Note that the existence of an operational database enablesthe exploitation of raw data Equally important isthe fact that they examine the application of artificial intelligence neural networks to improve the quality of the data Codifying and construction of the technological tool The technological solution implemented businessintelligence hasbeen constructed by integrating the following Open Source toolsto work asa unique software Database or Data Warehouse artificial intelligence and data mining WEKA multidimensional data server Mondrian Reporting Pentaho Reports Balanced Scorecard Pentaho Dashboards and Information System geographic representation orGIS Googl
40. ious 365 day Inicio Skype 2 Igcast Select benchmarks Sant Final Technical aspect of Tool 2 Microsoft Excel Santan e Select benchmarks F Technical aspect of Tool B a 2 WA 18 35 E Select benchmarks cj lt B https www bevaley com isf graph view seam conversationtd 27665 select benchmarks Hotmail gratuito 7 Personalizar v nculos 7 Windows Media Windows StoCon Pul svenska Other bookmarks https www bevaley com isf indicator view seam conversationId 19366 wo x SIDARTHA Luis Garcia Castrillo beta E Hotmail gratuito 7 Personalizar v nculos 7 Windows Media 7 Windows 7 StoCon Pul svenska 5 Other bookmarks Profile messages Log out j P evaile 1 updated fo date 2 2 Prediction benchmarks s FILTER ulta gt Infecci n Tipo Gripe ITS cl 3664 NE mO c2 4003 NE Static filters Measure Time filter Benchmarks Saveandexit Discard 3 4083 mE cusum mmo 4 024 STATIC et Tiempo Fecha de da B2 Urger Urgencia Gravedad gt ante demorable admisi n Urgencia Motiv n Data updated to date 2 27 11 10 25 Temporal filters arima 2 224 179 9 raised mero de casos x y 00 AR 2 547 soc EN 50 5 filler 148 1 Fecha d
41. king the country of 3 Lam mainly currently working at the following level 31 O supranational level 33 O subnational state regional level 3 2 national level 3 4 local level SIDARTHa Project Survey Syndromic Surveillance in Europe 1 SIDARTHa 2010 SIDARTHa Technical Guidelines 2nd European Public Health Conference 27 November 2009 UTILITY SYNDROMIC SURVEILLANCE 4 have experience in syndromic surveillance gt gt gt gt please go to question 6 page 3 IF YES use syndromic surveillance please tick all that appl 41 Llinevery day public health practice 42 Oin every day health care practice 4 3 O in every day decision making 44 Qn scientific methodological work 45 Oin special events mass gatherings disasters situational awareness 46 O other 5 the following 5 characteristics of syndromic surveillance are most important please tick up to five boxes 5 1 5 2 5 3 5 4 5 5 5 6 5 7 5 8 5 9 5 10 5 11 5 12 5 13 Timeliness between event and reporting Timeliness compared to laboratory based or sentinel surveillance Data quality accuracy Validity Predictive Value Flexibility of the approach rapid setup adjustment of data analysis data source selection utility for different public health questions Cost effectiveness Low workload Usefulness for every day surveillance work as supplem
42. ks 23 C https www bevaley com isf graph view seam conversationId 23998 select benchmarks E Hotmail gratuito Personalizar v nculos Windows Media Windows 7 StoCon Pul svenska C Other bookmarks https www bevaley com jsf indicator view seam conversationId 19366 wea i z J SIDARTHA Luis Garcia Castrillo beta Hotmail gratuito Personalizar vinculos Windows Media Windows StoCon Pul svenska CJ Other bookmarks Profile messages Log out L J a valley network Fiter Measure Time filter Benchmarks Save and exit Discard Data updated to date 2 27 11 10 25 Tunes Static filters Measure Time fiter Benchmarks Saveandexit Discard mai iem ci n Tip TC Paciente Data updated to date 2 27 11 10 25 AM Dee STATIC FILTERS Paciente Edad Urgencia Gravedad gt B2 Urgente dernorable Urgencia Motivo Consul Paciente Sexo 179 9 Data set Tiempo Dia de la N mero de basos 2010 11 28 76 0 semana Tiempo Hora de 148 1 Admisi n Urgencia uam Gravedad 116 MEASURE Urgencia Motivo N mero de casos Consulta 84 5 Urgencia MEASURE Diagn stico Wmero de caso Urgencia Servicio 52 7 Selected filters 20 9 Urgencia Motivo Consulta gt Infecci n iate Tipo Gripe TG 5 TIME FILTER Tiempo Fecha de admisi n Previous 1 day D imit SR TIME FILTER u Tie npo Fe ad 1 PF xl TP cha de admisi n Prev
43. lemented the main hospital in Cantabria Hospital Universitario Marqu s de Valdecilla Humvees and also with the cooperation of the Universty of Cantabna UC FEASIBILITY STUDY 1 preparatory fortwo smultaneous expenmental development projects Following the completion of this first tool prototype QUIVER and again in collaboration with the HUMVs and its Institute for Training and Research IHMAV be Valley Health Technologies supports and conducts a feasibility of preparatory characterforthe implementation of two experimental development projects which to be perfomed in a single social space on innovation living lab EXPERIMENTAL DEVELO PM ENTIN THE LAB OF LIVING of 35 CAP PUINV Prototype and C MIBI Prototype These experimental development projects were the bass for the realization of two prototypes of tools that integrate and Bl technologies based on Open Source to collect and exploit the living lab data data from the HUMV IHMAV and 35 primary care centersin Cantabria The first prototypes PUINV prototype sought to increase and improve research capacity whereasthe prototype CMIBI was aimed at supporting decison making for health professionals In both cases the funding was provided by the company Be Valley Technologies the HUMV and Sodercan through a Technology Govemance Plan regionally The experience in the use of a social space of the innovation together with the experience of HUMV and IFM
44. lines 3 3 SIDARTHa Syndromic Sur veillance Application The core of the SIDARTHa syndromic surveillance system Is the automated SIDARTHa application This piece of software enables the automated analysis of the data and display of results production of standard reports and exchange with other users via the internet password restricted access The technical architecture of this application is described in the following section The SIDARTHa application 15 based on a business intelligence platform developed by BeValley Technologies for web based hospital data analyses in Spain called BeValley Health Appendix 2 provides an overview on the technical development of this generic fundament of the SIDARTHa application All information from the SIDARTHa application is stored in a data warehouse The database of the data warehouse is designed to increase the performance in data analysis namely that it is ready to exploit the information with available business intelligence tools R Project Calcula las metas Figure 6 Technical setup of the SIDARTHa syndromic surveillance application Bvh BeValley Health dWh Data Ware House ETL Extract Transfer Load SIDARTHa 2010 The SIDARTHa application is based on Boss Seam to ensure that no user can access data they should not The technological architecture of the underlying BeValley Health platform has been based on the following components if possible based on open
45. lya Dr Hakan Yaman Sercan Bulut 14 AKFAM TR The country consortia consist of emergency medical care institutions and local regional public health authorities New Country Consortium leading organisation from September 2009 Netherlands Maastricht University Department of International Health Prof Helmut Brand Dr Genc Burazeri Nicole Rosenkotter Janneke Kraan Scientific Technical partners Associated Partners Technical Unit GEOMED Research Forschungsgesellschaft mbH Germany Dr Thomas Krafft Alexandra Ziemann Tim Tenelsen Martina Schorbahn Nico Reinke Dr Axel Kortevo amp 2 GEOMED DE University of Bielefeld Department of Public Health Medicine Germany Prof Alexander Kr mer Dr Paulo Pinheiro 15 UniBi DE Netherlands Maastricht University Department 01 International Health Prof Helmut Brand Dr Genc Burazeri Nicole Rosenkotter Janneke Kraan External Scientific Advisory Board Prof Helmut Brand Maastricht University Netherlands Chair Dr Andrea Ammon European Centre for Disease Prevention and Control Sweden Dr Enrico Davoli World Health Organization Regional Office for Europe Division of Country Health Systems Spain Dr Per Kulling Dr Franz Karcher European Commission Health Threat Unit Luxembourg SIDARTHa Technical Guidelines Vill Prof Francisco Javier Llorca Diaz University of Cantabria Spain Jerry Overton MPA Inte
46. nne 21 APPENDIX 2 TECHNICAL DEVELOPMENT OF HEALTH een 25 APPENDIX 3 SIDARTHA APPLICATION SETUP DATA BASE CONTENTS sssssssesssesssesssesseussarseesserssessenssarseussenseessenseneys 32 SIDARTHa 2010 SIDARTHa Technical Guidelines IV Figures FIGURE LE SIDAR VIA PROJECT METHODOLOGY R Ra aa an a QS 2 FIGURE 2 SIDAR THA APPROACH er Re Re ri Ne ee Na ete no 2 FIGURE 3 COMPONENTS OF SYNDROMIC SURVEILLANCE SYSTEMS 5 FIGURE 4 SIDARTHA SYNDROMIC SURVEILLANCE SYSTEM DESIGN VERSION 2 1 FIGURE 5 SIDARTHA SYNDROMIC SURVEILLANCE SYSTEM DESIGN REGIONAL LEVEL VERSION 2 1 FIGURE 6 TECHNICAL SETUP OF THE SIDARTHA SYNDROMIC SURVEILLANCE APPLICATION 9 FIGURE 7 SIDARTHA SHORT SURVEY a rod b 9 FIGURE 02 SIDAR THA APPLICATION FILE FORMAT 25 c v ar 12 SIDARTHa 2010 SIDARTHa Technical Guidelines Abbreviations 14 AKFAM TR ARIMA Bvh 1 02 G CUSUM D7 dWh ECDC ED EED EHSS EMD EMS ETL EU FAQ 8 FOD Health DG1 BE 2 DE 15 16 HSanMartino IT 17 HUS NO ICD ILI IT 1 DE 9 KUH FI LHSS 4 LST Tirol AU M 15 NLP 5 OMSZ HU
47. ogies and the Scientific Technical Coordination Office The authors would like to thank all project group members for their contributions Country Consortia leading organisations Associated Partners Austria Dispatch Centre Tyrol Ing Gernot Vergeiner Andreas Maurer 4 ILL GmbH AU Belgium Federal Government Department of Public Health Dr Agnes Meulemans Dr Jean Bernard Gillet 8 FOD Health DG 1 BE Czech Republic Emergency Medical Service Prague Dr Milana Pokorn Dr Petr Zajicek 13 ZZSHMP USZS 7 Denmark Capital Region Prof Freddy Lippert 3 RegH DK Finland University Hospital Kuopio Dr Jouni Kurola Dr Tapio Kettunen 9 FI France Emergency Medical Service Province Hauts de Seine Dr Michel Baer Dr Anna Ozguler 6 SAMU FR Germany Hospitals of the County of Goeppingen Prof Matthias Fischer Dr Martin Messelken 7 KAE DE Hungary National Emergency Medical Service Dr Gabor G bl 5 OMSZ HU italy San Martino University Hospital Genoa Prof Francesco Bermano Dr Lorenzo Borgo 16 HSanMartino IT Norway Haukeland University Hospital Bergen Dr Guttorm Brattebg Lars Myrmel 17 HUS Spain University of Cantabria Prof Luis Garcia Castrillo Riesgo Weyma Notel Juan Jose San Miguel Roncero Prof Francisco Javier Llorca Diaz 1 UNICAN ES SIDARTHa 2010 VI Turkey University Hospital Anta
48. ogies to generate a login and password to use the Demo Version for free After having logged in the user must type in demo sidartha in the search field on top of the page The geographical component is disabled in the demo version for confidentiality reasons searching machine demo Sidartha and you will have access to a Demo Sidartha data base and two indicators one graph with Respiratory Syndrome and the alert indicator On the SIDARTHa syndromic surveillance system website further supporting documents for users are available in the form of this user manual and the coding manual after approval by the EU www sidartha eu surveillancesystem htm Further supporting material can be found on the SIDARTHa website in the form of all work package reports or publications Individual support for users for questions related to the contents and the SIDARTHa approach is provided by the SIDARTHa consortium via the SIDARTHa Scientific Technical Coordination Office which functions as central contact point Technical support and guidance is provided by the provider of the software BeValley Technologies wia video tutorials webinars FAQ lists and individually a contact link in the software O SIDARTHa 2010 SIDARTHa Technical Guidelines 4 2 Download amp Setup The SIDARTHa application can be downloaded under the following two links to the generic platform BeValley and the SIDARTHa module BeValley http download
49. ology During conceptualisation phase information on international state of the art in the early detection of health threats and on the current practice of health surveillance and alert systems in Europe are brought together with the possibilities of emergency data for detection of health threats and specific public health authority and emergency professional desires for SIDARTHa s system features On this basis the surveillance system SIDARTHa 15 tested and evaluated during the implementation phase in different regions cf Figure 1 The project group constitutes a high level expert panel of emergency professionals public health experts and health 1 www eed network eu 2 SIDARTHa Implementation sites District of Kufstein Austria Capital Region Denmark County of Goeppingen Germany Autonomous Region Cantabria Spain SIDARTHa 2010 authority representatives under guidance of an interdisciplinary steering committee A sequence of focused methods such as group discussions Strengths Weaknesses Opportunities Threats analysis of existing procedures half Standardised surveys to seek input from potential futures users Statistical analyses and modelling and geo processing methods are applied Expected Results amp Products The SIDARTHa project provides a methodology and software application for syndromic surveillance at the regional level in Europe based on routinely collected emergency data The SIDARTHa syndr
50. omic surveillance system automatically analyses the actual demand for emergency services and detects temporal and spatial aberrations from the expected demand The system will automatically alert decision makers in the emergency medical institution and the regional public health authority Via the established reporting ways the regional public health authority can inform national or supranational authorities on an event cf Figure 2 It is expected that SIDARTHa improves the timeliness and cost effectiveness of European and national health surveillance by providing a basis for systematic syndromic surveillance that supplements the existing surveillance structures The main outputs of the project are a syndromic surveillance application software publicly available free of charge and guidelines for future users on how to use the application and how to transform emergency data into syndromes and into the common SIDARTHa data set that the application can analyse including recommendations on technical infrastructure reporting procedures and interpretation of the results Furthermore the guidelines cover the utilisation of the interactive user display and risk communication platform 3 n the SIDARTHa project the term regional is used referring to the smallest administrative level at which a health authority responsible for surveillance and reporting 15 established in a European country depending on the national definition and rules This level
51. orld Health Organization 0 SIDARTHa 2010 SIDARTHa Technical Guidelines Objectives amp Methodology 2 1 Objectives The main objective of this report 15 to provide a technical guideline or handbook for future users of the SIDARTHa syndromic surveillance system The report describes the technical features i e the system design data flow analysis Steps and reporting functions Task 10 of WP 6 also including the requirements and wishes of potential future users Task 9 SIDARTHa 2010 2 2 Methodology A systematic literature and internet review was accomplished for existing syndromic surveillance system designs by 2 GEOMED DE Next to the structured review of Medline indexed articles that were selected as part of WP 4 cf Ziemann et al 2009 1 a Google search was done starting with those existing systems that were described in the scientific literature identified in WP 4 and references included in these articles to other systems groups system descriptions and system evaluations 21 established syndromic surveillance systems were identified For each of these syndromic surveillance systems information was retrieved from the articles and from internet content published by the system providers covering the categories system description flow chart figure system evaluation manuals and miscellaneous During the first Technical Workshop the implementation site representatives and the technical unit came togethe
52. ow IL IN lt Unrestricted Pr ous 9 0 aciones Cantabria Mast used data sets e Valdecilla bas la A naw Adata file 2 Inicio 2 Sant Final bw Technical aspect of Tool i wall pern Chrome 2 3 Y 19 36 All functions are accessible from the Wall Data upload Generation or change of indicators analyses Change of alert thresholds Generation of labels SIDARTHa 2010 Data Upload Data files can be uploaded manually or automatically using an ETL application In the current version of the application the uploaded files must be Excel files They can contain an unlimited number of cases The data files should follow the SIDARTHa Standard Data Set cf Coding Manual Garcia Castrillo Riesgo et al 2009 2 and contain the minimum data fields of date case and geographical information for map representation Each row represents a case SIDARTHa Technical Guidelines 14 gt https www bevaley com isffeasyUpload selectFile searn Hotmail gratuito 3 Personalizar v nculos Windows Media Windows StoCon Pul svenska SIDARTHA Luis Garcia Castillo Profile messages Log out Upload data set file C Other bookmarks Select file ce can upload files in the following formats and xlsx 1 INVITATIONS AVAILABLE ISSUES AND SUGGESTIONS ENTITIES FAQ LEGAL DEVELOPERS MODE It is recommended to check the uploade
53. patch Centre Tyrol Austria Month of the SIDARTHa project Medical Intelligence System Natural Language Processing SIDARTHa associated partner abbreviation for the National Emergency Medical Service Hungary SIDARTHa associated partner abbreviation for the Capital Region Denmark SIDARTHa associated partner abbreviation for the System of Emergency Medical Assistance Garches France European Emergency Data based System for Information on Detection and Analysis of Risks and Threats to Health Service Oriented Architecture Structured Query Language SIDARTHa Technical Guidelines 15 UNIBI DE 1 UNICAN ES URL USA WP WHO 13 ZZSHMP USZS CZ SIDARTHa 2010 SIDARTHa associated partner abbreviation for the University of Bielefeld Germany SIDARTHa associated partner abbreviation for the University of Cantabria Spain Uniform Resource Locator United States of America Work Package of the SIDARTHa project World Health Organization SIDARTHa associated partner abbreviation for the Emergency Medical Service Prague Czech Republic vi SIDARTHa Technical Guidelines Acknowledgements This report presents the results of the Work Package WP 6 of the European Commission co funded project SIDARTHa European Emergency Data based Syndromic Surveillance System and forms deliverable D7 as defined in the Grant Agreement No 2007208 The results presented in this report were compiled by 1 UNICAN ES BeValley Technol
54. r veillance System Design Based on the results of the state of the art analysis the technical working group redesigned the first draft of the SIDARTHa syndromic system design cf Annex to the Grant Agreement to what is shown in Figure 4 and Figure 5 The syndromic surveillance system can be installed at single emergency institutions or also at regional level where data from single emergency institutions is transferred to another or a higher institution Baselines and thresholds must be calculated based on historical data separately for each of the emergency data sources EMD EMS ED in one region Data one case from different data sources should not be merged this poses too many threats to the approach and there is no actual need e g missing cases duplicates are not affecting the approach as baselines are taking into account solely the historical demand portability of the approach will be higher as institutions in one area do not depend on each other and raw data does not have to leave the institution region The emergency institution which installs SIDARTHa needs to write a translation between the own emergency data base the individual data field names of another language and different field contents and the SIDARTHa application This can be done for example by creating an Extract Transfer Load process ETL which the IT administrator of the institution will be able to programme The query will be permanently installed and
55. r with additional experts for statistical modelling and software programming to discuss the different established approaches towards system design Based on this international state of the art analysis the technical working group agreed on system design for the SIDARTHa syndromic surveillance system During Technical Workshop Il the system design was revised based on the first experiences by setting up the beta version of the system in the Spanish implementation site 1 UNICAN ES works together with the company Be Valley Technologies which provides data analysis applications based open source software for health institutions in Spain This company was chosen by the Steering Committee to be the main partner for software development automatic SIDARTHa syndromic surveillance application to the SIDARTHa project group instead of having partners in each implementation site This will allow for a standardised application fostering the acceptance of the system Funds for this cooperation are provided as own contribution by 1 UNICAN ES from a local grant successfully applied for together with Be Valley Technologies as part of a wider cooperation project During 4 SIDARTHa Implementation sites District of Kufstein Austria Capital Region Denmark County of Goeppingen Germany Autonomous Region Cantabria Spain SIDARTHa Technical Guidelines the setup phase Be Valley Technologies has developed a first beta version comprising automa
56. rnational Academies of Emergency Dispatch USA Dr Santiago Rodriguez Health Service Cantabria Spain Prof Mark Rosenberg Queen s University Department of Geography and Department of Community Health and Epidemiology Canada SIDARTHa 2010 SIDARTHa Technical Guidelines 1 Introduction The SIDARTHa Project Syndromic surveillance can detect public health threats earlier than traditional surveillance and reporting systems Pre hospital emergency medical services EMS and emergency medical dispatch centres EMD and in hospital emergency departments ED across Europe routinely collect electronic data that provides the opportunity to be used for near real time syndromic surveillance of communicable and non communicable health threats such as heat related diseases or Influenza Like lllness ILI The European Commission co funded project SIDARTHa Grant Agreement No 2007208 for the first time systematically explores the use of emergency data to provide a basis for syndromic surveillance in Europe The project runs from June 2008 until December 2010 It is an initiative of emergency medical professionals organised in the Furopean Emergency Data EED Research Network Objectives The objective of the European project SIDARTHa is to conceptualise develop implement test and evaluate the European Emergency Data based System for Information on Detection and Analysis of Risks and Threats to Health SIDARTHa Method
57. rtium during the Third European Public Health Conference in Amsterdam Netherlands between November 10 and 13 2010 23 participants The survey can be found in Appendix 1 The actual test and evaluation by future users during the implementation phase WP 7 was another more practical way to adjust the system to user wishes and requirements SIDARTHa 2010 SIDARTHa Technical Guidelines 5 j SIDARTHa Syndromic Surveillance System Design 3 1 State of the Art Syndromic Surveillance System Design The review of system designs from the literature and internet sources resulted in a common format or template of components of a State of the art syndromic surveillance system Figure 3 Data Collection Data Classification Data Warehousing amp Database Encapsulation Outbreak detection User Interfaces Communication Network Implementation amp Usage Evaluation amp Validation Data Warehousing amp Outbreak Data Collection Data Classification Database Encapsulation Detection Interfaces Classification amp Aggregation amp Grouping Stratification Cleansing amp Integrity Transfer Data 23 Communication amp Network 3 Applications Automatic Data Processing GIS Geographical Information System NLP Natural Language Processors Figure 3 Components of Syndromic Surveillance Systems SIDARTHa 2010 SIDARTHa Technical Guidelines 3 2 SIDARTHa Syndromic Su
58. selects and translates those data variables from the emergency institution s data base that the SIDARTHa application can automatically process the standardised SIDARTHa data set cf SIDARTHa Coding Manual Garcia Castrillo Riesgo et al 2009 2 The SIDARTHa application automatically and periodically analyses the continuously updated SIDARTHa data set at a regular basis e g daily different temporal detection algorithms will be applied providing results based on different baselines and thresholds that are calculated for the day The application provides a simple overview if a threshold is exceeded or not alert clock dashboard Detailed information can be accessed and various analyses of the data can be chosen by the user The regional administrator of the SIDARTHa system can grant access to any staff member or stakeholder to see the alerts and analysis results online The response to an alert will need communication and collaboration between regional public health authorities and emergency professionals The regional public health authority can inform regional or national authorities following the established national reporting ways Via national authorities the European institutions and networks can be informed The 0 SIDARTHa 2010 application also enables cross border or just cross region sharing of information A direct links to the EU Medical Intelligence System MedlSys is explored SIDARTHa Technical Guidelines
59. sion it must be one the following values Trimestre 1 Trimestre 2 Trimestre 3 Trimestre 4 or Unknown We are working to improve this so you can see the quarters in your own language month The month In the current version it must have the format mm nnnnnn where mm is the month number using two digits and nnnnnn is the month name in the default locale of the Java VM It may be Unknown too day of month The day the month or Unknown The date itself in MySQL native DATE format or NULL for Unknown ime the times of the emergencies are stored in this table It has the following columns ID of the time Use this ID for referencing the centre from other tables The hour It must have the format hh where hh is the hour using two digits from 00 to 23 It may be Unknown 00 time The time It must have the format hh mm where hh is the hour using two digits from 00 to 23 and mm is the minutes using two digits from 00 to 59 It may be Unknown too The time itself in MySQL native TIME format or NULL for Unknown department the departments of the hospital are stored in this table It has the following columns description gender the times of the emergencies are stored in this table It has the following columns description ID of the gender Use this ID for referencing the centre from other tables Use FEMALE for ID 1 MALE for ID 2
60. t Javier Llorca Spain Jerry Overton USA Santiago Rodriguez Spain Mark Rosenberg Canada Coordination Office Alexandra Ziemann Science Officer Weyma Notel Project Assistant Juan Jos San Miguel Roncero Financial Officer SIDARTHa Technical Guidelines How to use the European Emergency Data based Syndromic Surveillance System SIDARTHa This report describes the technical setup and provides a guideline for implementation of the SIDARTHa syndromic surveillance system for early public health threat detection and risk communication and forms deliverable D7 as defined in the Grant Agreement Compiled by Luis Garcia Castrillo Riesgo Alexandra Ziemann and Ronny Conde Editors Luis Garcia Castrillo Riesgo Alexandra Ziemann Thomas Krafft Ronny Conde Matthias Fischer Gernot Vergeiner Freddy Lippert Alexander Kramer Helmut Brand for the SIDARTHa project group Please cite as Garcia Castrillo Riesgo Ziemann A Krafft T Conde R Fischer M Vergeiner G Lippert Kramer A Pinheiro P Brand H for the SIDARTHa project group ed 2010 SIDARTHa Technical Guidelines How to implement the European Emergency Data based Syndromic Surveillance System SIDARTHa Bad Honnef Cover Figure SIDARTHa Syndromic Surveillance System Design own creation 0 SIDARTHa 2010 SIDARTHa Scientific Technical Coordination Office c o GEOMED Research Forschungsgesellschaft mbH Hauptstr 68 53604 Bad Honnef Germany Tel 49 2224 1199896 Fax
61. tic data analysis with the detection algorithms automatic alerting reporting function standardised report an interactive display where further temporal and spatial analysis functions can be chosen and the Option to share analysis results for risk communication and comparison The originally planned Delphi type study to identify external potential future user s desires for system features was adjusted during Steering Committee Meeting V towards a more targeted approach of a short half standardised potential future user survey to be distributed at special events such as European conferences The survey covers the following aspects Your Role area of expertise work country administrative level regional national etc Utility of Syndromic Surveillance experience in syndromic surveillance area of application of syndromic surveillance top five characteristics of syndromic surveillance reasons for non use of syndromic surveillance Design of Syndromic Surveillance Systems Top five characteristics of the optimal syndromic surveillance system Finally Usefulness of syndromic surveillance in Europe age and gender of the interviewee The survey was distributed among 20 participants of the workshop Syndromic Surveillance in Europe Needed or Needless organised by the SIDARTHa consortium at the Second European Public Health Conference in Lodz Poland on November 27 2009 and at two presentations by the SIDARTHa conso
62. usefulness for event detection Data quality and accuracy was seen as another crucial aspect of syndromic surveillance Those not having experience with syndromic surveillance gave the following top four reasons no collaboration with data providers missing expertise missing infrastructure and no suitable data that 15 collected The overall answer if syndromic surveillance is a useful concept was clearly answered with yes figure 7 The main issue raised as reason why public healt professionals do not use syndromic surveillance the missing collaboration with data providers 15 overcome in the SIDARTHa project being an initiative of the data providers themselves This makes sure that most is made out of the available data and correct assumptions and interpretations have experience in syndromic surveillance RETENIR E ET T E IRR ER RR ER RE E T ER are drawn based on the data Nevertheless the link between emergency care and public health authorities in the use of SIDARTHa must be strengthened in the pilot regions SIDARTHa can also be a chance to enhance regional collaboration in public health crisis but also in every day business The main uses of syndromic surveillance special event surveillance event detection are covered by SIDARTHa as it applies a flexible and braod approach Timeliness is given using a daily and automated analysis of data Data quality is assured by standardised automated data transfer and analysis B
63. xt Results from the SIDARTHa project 2009 Bad Honnef 2 Garcia Castrillo Riesgo L Krafft T Ziemann A Fischer M Lippert Vergeiner Kramer A Brand H for the SIDARTHa project group eds The SIDARTHa Coding Manual How to generate syndromes based on routinely collected emergency care data for the European syndromic surveillance system SIDARTHa 2009 Bad Honnef SIDARTHa 2010 SIDARTHa Technical Guidelines Appendix SIDARTHa 2010 20 SIDARTHa Technical Guidelines Appendix 1 SIDARTHa 2010 SIDARTHa Short Survey on User Requirements SIDARTHa Technical Guidelines eee SIDARTHa European Emergency Data based Syndromic Surveillance System COGUO This project is co funded the European Commission CREER molle ss sare DG Health amp Consumers 2007208 WWW Sidartna e t eo 9 Survey Syndromic Surveillance in Europe Needed or Needless Background This survey is set within the framework of the European Commission co funded project SIDARTHa European Emergency Data based Syndromic Surveillance System Grant Agreement No 2007208 project time June 2008 December 2010 The aim of the project is to contribute to and to enhance the generic preparedness of the health sector for communicable as well as non communicable health threats and emergencies by conceptualising developing implementing testing and evaluating an innovative syndromic surveillance system

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