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ISDS 2012 Conference Abstracts

SurSaUD® Software: A Tool to Support the Data
Management, the Analysis and the Dissemination of
Results from the French Syndromic Surveillance System
Anne Fouillet*1, Nelly Fournet1, Nadege Caillère1, Arnaud Musset1, Lucas Mercier1, Cécile
Durand1, Céline Caserio-Schönemann1 and Loic Josseran2

1French Institute for Public Health Surveillance (InVS), Saint Maurice, France; 2Université de Versailles St-Quentin-en-Yvelines
(UVSQ), Montigny-Le-Bretonneux, France

Objective
The presentation describes the design and the main functionalities

of the software developed to support the data management and data
analysis of the French syndromic surveillance system.

Introduction
The French syndromic surveillance system SurSaUD® was set up

by the French institute for public health surveillance (InVS) in 2004.
The system is based on three main data sources: 1/the attendances in
the Emergency departments (ED), 2/the consultations to emergency
General Practitioners’ associations SOS Médecins 3/the mortality
data from civil status offices and e-certificates. 

In 2012, 400 of the 710 ED and 59 of the 62 GP’s associations are
involved in the system. 80% of the national mortality is also collected.
Given this large database and the need to analyze data in a short delay
to reach the early warning objective of the system, a specific soft-
ware has been developed.

Methods
The application has been designed in order to support the users

with automatised process of the three main following steps:
1. Data integration in a database, data management and the control

of data quality transmitted by the providers 
2. The statistical analysis of the data, according to different de-

mographic, geographic and syndromic criteria. Individual and ag-
gregated data are consultated using reporting tools (graphs and
tables).

3. The output and reporting for decision makers and feedback for
data providers through epidemiological bulletins and dashboards.

Each night, XML files containing data recorded during the previ-
ous day are sent from the ED and GP’s association SOS Médecins to
InVS. All files are automatically integrated in the national database.
A data quality process is done to check the completeness and the va-
lidity of the transmitted data. The data are managed by aggregating
by age groups, syndromes, by day and ED or association.

After the data management, bulletins and dashboards are auto-
matically generated. Those Word® documents contain graphs, tables
or maps with the most recent data. This functionality allows produc-
ing already formatted documents, including an updated overview of
the health situation of the previous days. Through those documents
available at 10:30 AM every day, the epidemiologists can analyse,
add comments of the results and publish their bulletins in a short
delay. 

The users can also consult aggregated data through a BI tool to
have a more in-depth analysis of the public health. Such tool can also
support the investigation of abnormal signals.

Results
Sursaud software is a login and password-protected and secured

internet web site. Since its deployment in 2010, about 300 users have
had an access to the software and 25% are data providers.

In August 2012, almost 35,000 new patients are daily caught by the
system and nearly 50 millions of patients are recorded in the data-
base since 2004.

To analyse data, the diagnosis coded either in ICD10 for ED vis-
its or with specific thesaurus for GP’s calls are pre-aggregated in
about 200 syndromes covering a large part of the medical diagnosis
and call reasons collected in the system. 22 age groups are also avail-
able with a focus on the most frailty population, like the youngest
and the elderly. Finally, various geographic levels can be chosen,
from the local ED or association to the national level.

An average of 25 bulletins or dashboards is daily produced by the
software and about 10,000 documents have been produced since the
deployment. They support the analysis of general overviews of pop-
ulation health or are focused on the surveillance of specific health
situations, such as epidemics, emergent pathologies or exceptional
events (disasters, mass gatherings,…)

Conclusions
The software is a fundamental support for the French syndromic

surveillance system. A new version is being developed in order to
add improvements and integrate the mortality data. The deployment
of this second version is expected in 2013.

Keywords
software; France; Emergency department, General practitioners

References

1. Broome C, Loonsk J. Public health information network – Improving
early detection by using a standards-based approach to connecting
public health and clinical medicine. MMWR (2004) Vol53. Supple-
ment:199-202.

2. Josseran L, Nicolau J, Caillère N, Astagneau P, Brücker G. Syndromic
surveillance based on emergency department activity and crude mor-
tality: 2 examples. Euro Surveill 2006,11(12):225-29

*Anne Fouillet
E-mail: a.fouillet@invs.sante.fr

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 5(1):e118, 2013