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ISDS 2012 Conference Abstracts

Using Cloud Technology to Support Monitoring During
High Profile Events
Megan Patel*1, Enyinnaya Adighibe1, Joseph Lombardo2, Wayne Loschen2, Miles Stewart2
and Michael O. Vernon1

1Cook County Department of Public Health, Oak Forest, IL, USA; 2Johns Hopkins University Applied Physics Laboratory, Laurel, MD,
USA

Objective
In May 2012, thousands of protesters, descended on Chicago dur-

ing the NATO Summit to voice their concern about social and eco-
nomic inequality. Given the increased numbers of international and
domestic visitors to the Windy City and the tension surrounding
protesting during the summit, increased monitoring for health events
within the city and Chicago metropolitan region was advised. This
project represents the first use of cloud technology to support moni-
toring for a high profile event.

Introduction
Hospital emergency departments in Cook and surrounding coun-

ties currently send data to the Cook County Department of Public
Health (CCDPH) instance of ESSENCE on CCDPH servers. The
cloud instance of ESSENCE has been enhanced to receive and ex-
port all meaningful use data elements in the meaningful use format.
The NATO summit provided the opportunity for a demonstration
project to assess the ability of an Amazon GovCloud instance of
ESSENCE to ingest and process meaningful use data, and to export
meaningful use surveillance data to the Cook County Locker in
BioSense 2.0.

Methods
In the three weeks leading up to the NATO Summit, HL7 data ex-

tracts were sent to BioSense 2.0 and a data feed was established to the
Amazon GovCloud instance of ESSENCE. Queries specific to an-
ticipated health events associated with the summit such as injuries,
tear gas exposure, and general exposure, were developed. Several
features of the cloud instance of ESSENCE enhanced the ability of
CCDPH staff epidemiologists to conduct analyses, including the shar-
ing capabilities of queries and the myESSENCE dashboard feature.
The sharing capabilities within the cloud instance of ESSENCE al-
lowed queries to be easily shared with multiple staff epidemiologists

and across health jurisdictions. The myESSENCE dashboard feature
was used to create dashboards of surveillance results, including time
series graphs, maps, and records of interest for relevant queries, that
were shared with public health staff monitoring population health
during the summit. This information was used to provide situational
awareness on a daily basis in the Chicago Metropolitan region.

Results
Data feeds to BioSense 2.0 and the Amazon GovCloud instance

of ESSENCE were successful. The NATO Summit did not produce
any remarkable public health concerns in suburban Cook County. The
use of the cloud instance of ESSENCE enhanced the timeliness of
generating situational awareness reports for distribution to public
health partners in the Chicago Metropolitan region.

Conclusions
While further evaluation of cloud resources to conduct syndromic

surveillance is warranted, use of the cloud instance of ESSENCE dur-
ing the NATO Summit demonstrated the ability of the cloud to sup-
port surveillance for both routine and high profile events.

Keywords
Cloud; Meaningful Use; Surveillance; Public Health

Acknowledgments

This project was supported by the Wide Area Recovery and Resiliency
Program of the Department of Homeland Security under contract
N00024-03-6606. Cloud services were provided by the CDC’s BioSense
2.0 Program under contract 200-2011-40934.

*Megan Patel
E-mail: mctoth@gmail.com

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 5(1):e73, 2013