@article{MacDonald_Usman_Hinshaw_Meurer_Sikora_2017, title={Facilitating Public Health Action through Surveillance Dashboards}, volume={9}, url={https://ojphi.org/ojs/index.php/ojphi/article/view/7684}, DOI={10.5210/ojphi.v9i1.7684}, abstractNote={<div style="left: 78.2727px; top: 296.356px; font-size: 12.3207px; font-family: sans-serif; transform: scaleX(1.0823);" data-canvas-width="55.467823232323234">Objective</div><div style="left: 91.3182px; top: 309.359px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.06403);" data-canvas-width="332.9523237373739">To address the limitations of traditional static surveillance</div><div style="left: 78.2727px; top: 323.854px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.981741);" data-canvas-width="341.8749797979794">reporting by developing in-house infrastructure to create and maintain</div><div style="left: 78.2727px; top: 338.349px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.00139);" data-canvas-width="176.21075252525256">interactive surveillance dashboards.</div><div style="left: 78.2727px; top: 365.932px; font-size: 12.3207px; font-family: sans-serif; transform: scaleX(1.11884);" data-canvas-width="71.86668434343434">Introduction</div><div style="left: 91.3182px; top: 378.935px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.0405);" data-canvas-width="332.2660603535353">Traditionally, public health surveillance departments collect,</div><div style="left: 78.2727px; top: 393.43px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.03825);" data-canvas-width="343.4372454545453">analyze, interpret, and package information into static surveillance</div><div style="left: 78.2727px; top: 407.925px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.03161);" data-canvas-width="345.1756972222221">reports for distribution to stakeholders. This resource-intensive</div><div style="left: 78.2727px; top: 422.42px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.03776);" data-canvas-width="343.2906290404038">production and dissemination process has major shortcomings that</div><div style="left: 78.2727px; top: 436.915px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.997078);" data-canvas-width="342.11400151515153">impede end users from optimally utilizing this information for public</div><div style="left: 78.2727px; top: 451.41px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.975237);" data-canvas-width="344.0311035353538">health action. Often, by the time traditional reports are ready for</div><div style="left: 78.2727px; top: 465.905px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.02037);" data-canvas-width="342.7768555555556">dissemination they are outdated. Information can be difficult to find</div><div style="left: 78.2727px; top: 480.4px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.05226);" data-canvas-width="343.4569585858585">in long static reports and there is no capability to interact with the</div><div style="left: 78.2727px; top: 494.895px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.950693);" data-canvas-width="343.5013131313133">data by users. Instead, ad hoc data requests are made, resulting in</div><div style="left: 78.2727px; top: 509.39px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.00685);" data-canvas-width="124.88268686868687">inefficiencies and delays.</div><div style="left: 91.3182px; top: 523.884px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.999701);" data-canvas-width="331.46767853535334">Use of electronic dashboards for surveillance reporting is not</div><div style="left: 78.2727px; top: 538.379px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.0062);" data-canvas-width="342.3764325757576">new. Many public health departments have worked with information</div><div style="left: 78.2727px; top: 552.874px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.99713);" data-canvas-width="342.1152335858586">technology (IT) contractors to develop such technically sophisticated</div><div style="left: 78.2727px; top: 567.369px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.01624);" data-canvas-width="342.77931969696965">products requiring IT expertise. The technology and tools now exist</div><div style="left: 78.2727px; top: 581.864px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.992772);" data-canvas-width="341.99325858585854">to equip the public health workforce to develop in-house surveillance</div><div style="left: 78.2727px; top: 596.359px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.981224);" data-canvas-width="343.6245202020202">dashboards, which allow for unprecedented speed, flexibility, and</div><div style="left: 78.2727px; top: 610.854px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.975146);" data-canvas-width="343.6577861111111">cost savings while meeting the needs of stakeholders. At Alberta</div><div style="left: 78.2727px; top: 625.349px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.991851);" data-canvas-width="341.9735454545453">Health Services (AHS), in-house, end-to-end dashboard development</div><div style="left: 78.2727px; top: 639.844px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.0016);" data-canvas-width="342.2790989898989">infrastructure has been established that provides epidemiologists and</div><div style="left: 78.2727px; top: 654.339px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.962718);" data-canvas-width="343.35346464646483">data analysts full capabilities for effective and timely reporting of</div><div style="left: 78.2727px; top: 668.834px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.00153);" data-canvas-width="123.8723888888889">surveillance information.</div><div style="left: 78.2727px; top: 696.417px; font-size: 12.3207px; font-family: sans-serif; transform: scaleX(1.07424);" data-canvas-width="50.65042676767676">Methods</div><div style="left: 91.3182px; top: 709.42px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.981004);" data-canvas-width="328.8815621212121">An internal assessment of the available resources and infrastructure</div><div style="left: 78.2727px; top: 723.915px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.966564);" data-canvas-width="343.6134315656567">within AHS was conducted to iteratively develop a new analytics</div><div style="left: 78.2727px; top: 738.41px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.979776);" data-canvas-width="341.86019494949494">model that provides a foundation for in-house dashboard development</div><div style="left: 78.2727px; top: 752.905px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.01322);" data-canvas-width="342.435571969697">capacity. We acquired SAS® and Tableau® software and conducted</div><div style="left: 78.2727px; top: 767.4px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.02758);" data-canvas-width="342.8852777777775">internal training for skills development and to transition staff to the</div><div style="left: 78.2727px; top: 781.895px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.955374);" data-canvas-width="343.21793686868676">new model. This model is highlighted below using our respiratory</div><div style="left: 78.2727px; top: 796.39px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.00517);" data-canvas-width="252.18023232323233">virus surveillance (RVS) dashboard as an example.</div><div style="left: 91.3182px; top: 810.884px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.05178);" data-canvas-width="334.8004297979797">For the RVS dashboard, stakeholder engagements were</div><div style="left: 78.2727px; top: 825.379px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.00936);" data-canvas-width="342.52551313131306">conducted to understand the end users’ needs. Next, data access was</div><div style="left: 78.2727px; top: 839.874px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.039);" data-canvas-width="342.99123585858587">improved, where possible, by securing direct access to source data</div><div style="left: 78.2727px; top: 854.369px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.986681);" data-canvas-width="344.105027777778">(e.g. emergency department visits for influenza like illness (ILI),</div><div style="left: 78.2727px; top: 868.864px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.985465);" data-canvas-width="343.89434368686904">Health Link calls, hospital admissions, etc.) on existing database</div><div style="left: 78.2727px; top: 883.359px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.02375);" data-canvas-width="345.15844823232305">servers. SAS® code was written for routinely connecting with</div><div style="left: 78.2727px; top: 897.854px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.966391);" data-canvas-width="343.51979419191923">multiple data sources, data management and analysis, data quality</div><div style="left: 78.2727px; top: 912.349px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.00332);" data-canvas-width="323.78818181818167">assurance, and posting summary data on a secure Oracle® server.</div><div style="left: 91.3182px; top: 926.844px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.0194);" data-canvas-width="329.8425772727273">The Tableau® dashboard development application was then used</div><div style="left: 78.2727px; top: 941.339px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.956879);" data-canvas-width="343.7588159090912">to connect to the summary data on the Oracle® server, create the</div><div style="left: 78.2727px; top: 955.834px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.978848);" data-canvas-width="343.9670358585857">interactive dashboards and publish the final products to the AHS</div><div style="left: 78.2727px; top: 970.329px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.985665);" data-canvas-width="341.7135785353535">Tableau server environment. Key users were consulted in the iterative</div><div style="left: 78.2727px; top: 984.824px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.01479);" data-canvas-width="344.7925232323232">development of the interface to optimize usability and relevant</div><div style="left: 78.2727px; top: 999.319px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.00176);" data-canvas-width="39.35233838383838">content.</div><div style="left: 91.3182px; top: 1013.81px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.07505);" data-canvas-width="333.17532853535363">Finally, the product was promoted to stakeholders with a</div><div style="left: 78.2727px; top: 1028.31px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.00141);" data-canvas-width="337.75986363636355">commitment to use their feedback to drive continuous improvement.</div><div style="left: 443.545px; top: 296.356px; font-size: 12.3207px; font-family: sans-serif; transform: scaleX(1.08542);" data-canvas-width="44.50239393939395">Results</div><div style="left: 456.591px; top: 309.359px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.02651);" data-canvas-width="330.09022348484837">In-house generated surveillance dashboards provide more timely</div><div style="left: 443.545px; top: 323.854px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.04642);" data-canvas-width="345.50958838383843">access to comprehensive surveillance information for a broad</div><div style="left: 443.545px; top: 338.349px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.00256);" data-canvas-width="342.2914196969697">audience of over 108,000 AHS employees; within as little as 3 hours</div><div style="left: 443.545px; top: 352.844px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.03908);" data-canvas-width="343.12060328282837">of all data being available. They facilitate user-directed deep dives</div><div style="left: 443.545px; top: 367.339px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.034);" data-canvas-width="343.13292398989876">into the data to understand a more complete surveillance picture as</div><div style="left: 443.545px; top: 381.834px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.998209);" data-canvas-width="342.13617878787875">well as stimulating hypothesis generation. Additionally they enhance</div><div style="left: 443.545px; top: 396.329px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.03433);" data-canvas-width="343.2068482323233">productivity of personnel, by significantly reducing response times</div><div style="left: 443.545px; top: 410.824px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.04154);" data-canvas-width="343.1526371212121">for ad hoc request and to generate reports, freeing up more time to</div><div style="left: 443.545px; top: 425.319px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.00233);" data-canvas-width="232.35621464646465">respond to other emerging public health issues.</div><div style="left: 456.591px; top: 439.814px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.0205);" data-canvas-width="329.6392856060606">Looking specifically at the RVS dashboard, its ability to bring all</div><div style="left: 443.545px; top: 454.309px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.98398);" data-canvas-width="343.7206217171716">relevant surveillance information to one place facilitates valuable</div><div style="left: 443.545px; top: 468.804px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.03297);" data-canvas-width="343.1181391414136">discussions during status update meetings throughout the influenza</div><div style="left: 443.545px; top: 483.299px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.00713);" data-canvas-width="344.62249747474743">season. Among other things it has allowed Medical Officers of</div><div style="left: 443.545px; top: 497.794px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.968421);" data-canvas-width="343.14401262626257">Health, emergency department staff, epidemiologists and others to</div><div style="left: 443.545px; top: 512.289px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.963199);" data-canvas-width="343.38057020201995">make informed decisions pertaining to public messaging, the need</div><div style="left: 443.545px; top: 526.784px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.988492);" data-canvas-width="341.8700515151514">for reallocating resources, such as staffing and handling the burden of</div><div style="left: 443.545px; top: 541.278px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.983782);" data-canvas-width="341.5854431818181">ILI patients, as well as determining the necessity of opening influenza</div><div style="left: 443.545px; top: 555.773px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.00145);" data-canvas-width="95.8058181818182">assessment centers.</div><div style="left: 443.545px; top: 583.356px; font-size: 12.3207px; font-family: sans-serif; transform: scaleX(1.10408);" data-canvas-width="73.93656313131314">Conclusions</div><div style="left: 456.591px; top: 596.359px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.00567);" data-canvas-width="331.36911287878775">Surveillance dashboards can facilitate public health action by</div><div style="left: 443.545px; top: 610.854px; font-size: 12.3207px; font-family: serif; transform: scaleX(1.00316);" data-canvas-width="344.2676611111111">assembling comprehensive information in one place in a timely</div><div style="left: 443.545px; top: 625.349px; font-size: 12.3207px; font-family: serif; transform: scaleX(0.971139);" data-canvas-width="339.2999520202018">manner so that informed decisions can be made in emerging situations.</div>}, number={1}, journal={Online Journal of Public Health Informatics}, author={MacDonald, Adrienne and Usman, Hussain R. and Hinshaw, Deena and Meurer, David P. and Sikora, Christopher}, year={2017}, month={May} }