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ISDS 2016 Conference Abstracts

Regional Governance of Syndromic Surveillance for 
the Texas Gulf Coast
Wesley McNeely*, Eunice R. Santos, Biru Yang, Kiley Allred and Raouf R. Arafat
OSPHP, Houston Health Department, Houston, TX, USA

Objective
Describe and explain the transition of the syndromic surveillance 

program at the Houston Health Department (HHD) from being a 
locally managed and aging system to an ESSENCE system governed 
by a regional Consortium of public health agencies and stakeholders 
in the 13-county area of the southeast Texas.

Introduction
Syndromic surveillance systems are large and complex technology 

projects that increasingly require large investments of financial and 
political capital to be sustainable. What was once a minor surveillance 
tool in the mid-2000s has evolved into a program that is regarded 
as valuable to public health yet is increasingly difficult to maintain 
and operate for local health departments. The Houston Health 
Department installed a syndromic surveillance system (SyS) six 
years before Meaning Use became known to healthcare communities. 
The system chosen at the time was the Real-time Outbreak Disease 
Surveillance System (RODS) which, at the time and for its purpose, 
was a suitable platform for syndromic surveillance. During the past 
13 years however, maintaining, operating, and growing a SyS by a 
local health department has become increasingly difficult. Inclusion 
in Meaningful Use elevated the importance and profile of syndromic 
surveillance such that network growth, transparency of operations, 
ease of data sharing, and cooperation with other state systems in 
Texas became program imperatives.

Methods
With support from the informatics group at Tarrant County Public 

Health (TCPH) in the form of mentoring, HHD devised a two prong 
strategy to re-invigorate the syndromic program. The first was to 
replace RODS with ESSENCE from Johns Hopkins Applied Physics 
Laboratory (JH/APL). The second was to strengthen the regional 
network by creating a governance structure that included outside 
agencies and stakeholders. The product of this second effort was 
the creation of the Syndromic Surveillance Consortium of Southeast 
Texas (SSCSeT) on the Communities of Practice model1 using 
parliamentary procedure2.

Results
Acquiring ESSENCE and forming SSCSeT were necessary steps 

for the continuing operation of the SyS. The Consortium includes 
members from local health jurisdictions, health care providers, health 
policy advocates, academicians, and data aggregators. Created as 
a democratic society, SSCSeT wrote its constitution and by-laws, 
voted in officers, formed working groups and has begun developing 
policies. The Consortium is cooperating with the Texas Department 
of State Health Services (DSHS) as well as TCPH. Having ESSENCE 
will ensure the HHD-SyS will conform to standards being developed 
in the state and provide a robust syndromic platform for the partners 
of the Consortium.

Conclusions
Syndromic systems operated by local health departments can 

adapt to regulatory changes by growing their networks and engaging 
regional stakeholders using the Communities of Practice model.

Keywords
Communities of Practice; Texas; Gulf Coast; Syndromic Surveillance

Acknowledgments
The authors would like to acknowledge the support of Bill Stephens 
and Dave Heinbaugh of Tarrant County Public Health and members of 
the Syndromic Surveillance Consortium of Southeast Texas from the 
following jurisdictions:
●Beaumont Public Health Department
●Brazoria County Health Department
●Fort Bend County Department of Health and Human Services
●Galveston County Health District
●Harris County Public Health and Environmental Services
●Houston Health Department
●Montgomery County Public Health District
●Port Arthur Health Department
●Texas Department of State Health Services Region 6/5 South

References
1 Wenger, Etienne, McDermott, Richard, Snyder, William M. Cultivating 

Communities of Practice. Harvard Business School Press. Boston, 
MA. 2002.

2. Robert, Henry M,.et al., Robert’s Rules of Order Newly Revised
(11th ed.). Philadelphia, PA, Da Capo Press, 2011.

*Wesley McNeely
E-mail: wesley.mcneely@houstontx.gov

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 9(1):e79, 2017