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ISDS 2012 Conference Abstracts

Update from CDC’s Public Health Surveillance &
Informatics Program Office (PHSIPO)
James Buehler*, Laura Conn, Carol Crawford and Kathleen Gallagher

Centers for Disease Control & Prevention, Atlanta, GA, USA

Objective
To provide updates on current activities and future directions for

the National Notifiable Diseases Surveillance System (NNDSS),
BioSense 2.0, and the Behavioral Risk Factor Surveillance System
(BRFSS) and on the role of PHSIPO as the “home” at CDC for ad-
dressing cross-cutting issues in surveillance and informatics practice.

Introduction
The practice of public health surveillance is evolving as electronic

health records (EHRs) and automated laboratory information systems
are increasing adopted, as new approaches for health information ex-
change are employed, and as new health information standards affect
the entire cascade of surveillance information flow. These trends have
been accelerated by the Federal program to promote the Meaningful
Use of electronic health records, which includes explicit population
health objectives. The growing use of Internet “cloud” technology
provides new opportunities for improving information sharing and
for reducing surveillance costs. Potential benefits include not only
faster and more complete surveillance but also new opportunities for
providing population health information back to clinicians. 

For public health surveys, new Internet-based sampling and survey
methods hold the promise of complementing existing telephone-
based surveys, which have been plagued by declining response rates
despite the addition of cell-phone sampling. While new technologies
hold promise for improving surveillance practice, there are multiple
challenges, including constraints on public health budgets and the
workforce. This panel will explore how PHSIPO is addressing these
opportunities and challenges.

Methods
Panelists will provide updates on 1) PHSIPO’s role in engaging

health departments, the organizations that represent them, and CDC
programs in shaping national policies for implementing the Mean-
ingful Use program, 2) how the BioSense 2.0 program is supporting
growth in syndromic surveillance capacity, including its partnership
with ISDS in developing standards for syndromic surveillance as part
of Meaningful Use, 3) improvements that are underway in strength-
ening the NNDSS, including efforts to improve CDC’s support for
health department disease reporting systems and to develop a “shared
services” approach that could provide a platform for streamlining the
exchange of information between health departments and CDC, 4)
pilot development of Internet-based panels of survey volunteers to
supplement existing telephone-based sampling in the BRFSS and of
approaches to extend BRFSS survey information through consent-
based linkage of survey responses to selected measures recorded in
respondents’ EHRs.

Results
Potential questions or discussion points that might arise include:

What can or should be done to assure that the population health ob-
jectives of Meaningful Use are fulfilled? What are the lessons learned
to date in leveraging investments in the Meaningful Use of EHRs to
improve disease reporting and syndromic surveillance systems? What
are the next steps in developing BioSense 2.0 to assure that it leads
to strengthened surveillance capacity at both state/local and re-
gional/national levels? How can insights from the BioSense redesign
be applied to improve case reporting and other surveillance capaci-
ties? What is CDC doing to address states’ concerns about the grow-
ing number of CDC surveillance systems? How will national
discussions about the future of public health affect the future sur-
veillance practice? What can be done to assure the ongoing repre-
sentativeness of population health surveys? Is it feasible to link
BRFSS responses to information obtained from EHRs? How can data
from surveillance become part of the real-time evidence base for clin-
ical decision making?

Conclusions
The intended outcome of the panel is to foster a conversation be-

tween the panelists and the audience, to inform the audience about re-
cent developments in PHSIPO, to obtain insights from the audience
about innovations and ideas arising from their experience, and to gen-
erate new ideas for approaches to meeting the needs of public health
for surveillance information.

Keywords
Surveillance; BioSense 2.0; Notifiable Diseases; BRFSS—Behav-
ioral Risk Factor Surveillance System

Acknowledgments

The authors wish to acknowledge the many individuals from health de-
partments, academia, and other agencies who have contributed to the on-
going operation and improvement of the NNDSS, BioSense 2.0, and the
BRFSS.

References

For more information about PHSIPO, see: http://www.cdc.gov/osels/ph-
sipo

*James Buehler
E-mail: jwb2@cdc.gov

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 5(1):e98, 2013