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ISDS 2016 Conference Abstracts

Evaluating the application and utility of ESSENCE for 
early event detection
Allison K. Kunerth*, Elizabeth Baker, Alan Zelicoff, Michael Elliot and Kevin Syberg
Saint Louis University, Saint Louis, MO, USA

Objective
A mixed methods study is being conducted on the statewide Early 

Notification of Community Based Epidemics (ESSENCE) system 
in Missouri to identify factors that can improve the timeliness and 
identification of outbreaks. This research will provide stakeholders 
with guidance on how best to implement and improve ESSENCE 
usage statewide, and by sharing this research input can be solicited 
on the utility of the applied framework as well as future implications 
from this body of work.

Introduction
In spite of the noted benefits of syndromic surveillance, and 

more than a decade after it started gaining support, the primary use 
for syndromic surveillance appears to be largely for seasonal and 
jurisdictional disease monitoring, event response and situational 
awareness as opposed to its intended purpose of early event detection. 
(1-4) Research assessing the user characteristics and standards applied 
at local public health agencies (LPHA’s) for syndromic surveillance 
are scarce, and in national surveys epidemiologists frequently tend 
to utilize their own syndromic surveillance systems as opposed to 
a national system such as Biosense. While the National Syndromic 
Surveillance Program (NSSP) has addressed many operational 
concerns from stakeholders, and is in the process of providing access 
to the cloud based Biosense platform-along with ESSENCE as a key 
tool, there is still a paucity of research that exists as to what can be 
done to improve the utilization of syndromic surveillance systems for 
its primary purpose of early event detection.

Methods
This research proposes to evaluate the use of ESSENCE within 

Missouri and the surrounding areas, to comprehensively identify 
its strengths and limitations, through an assessment of the user 
experience. This research will evaluate three key areas: 1) the 
quality of the data received by the syndromic surveillance system, 
2) the characteristics of the individuals and organizations utilizing
the system (end-users), 3) the influence and extent of syndromic 
surveillance data on public health actions. ESSENCE data will be 
evaluated directly with special attention to the top three data quality 
attributes across the literature, completeness, accuracy and timeliness.
(5) A survey will also be administered to ESSENCE system users and 
public health leadership at LPHA’s, to gain insight into perspectives, 
perceptions and general practices, as well as how they interact with 
data from ESSENCE.

Results
The data for this research is primarily being collected throughout 

the fall of 2016, so the hope is to bring preliminary data to this 
conference as a means to validate some of the findings, solicit input 
on the proposed framework and share this research in a timely manner 
for the NSSP roll out of Biosense and ESSENCE.

Conclusions
Through a thorough evaluation, the application and utility of 

ESSENCE for early event detection will be better understood, along 
with the identification of factors that can be targeted in the future 

(and across syndromic surveillance platforms) for improvement in the 
timely identification of outbreaks.

Keywords
ESSENCE; syndromic surveillance; data quality

Acknowledgments
The data for this research is supplied by the Missouri Department of 
Health and Senior Services.

References
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et al. The use of syndromic surveillance for decision-making during 
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*Allison K. Kunerth
E-mail: akunerth@slu.edu

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 9(1):e85, 2017