ISDS Annual Conference Proceedings 2017. This is an Open Access article distributed under the terms of the Creative Commons Attribution-
Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution,  
and reproduction in any medium, provided the original work is properly cited.

ISDS 2016 Conference Abstracts

Civilian-military Collaboration: Department of Defense 
data in the BioSense Platform
Jessica F. Deerin*, Jean-Paul Chretien and Paul E. Lewis
Armed Forces Health Surveillance Branch, Arlington, VA, USA

Objective
The Department of Defense data is available to National 

Syndromic Surveillance Program (NSSP) users to conduct syndromic 
surveillance. This report summarizes the demographic characteristics 
of DoD health encounter visits.

Introduction
The DoD provides daily outpatient and emergency room data feeds 

to the BioSense Platform within NSSP, maintained by the Centers 
for Disease Control and Prevention. This data includes demographic 
characteristics and diagnosis codes for health encounter visits of 
Military Health System beneficiaries, including active duty, active 
duty family members, retirees, and retiree family members. NSSP 
functions through collaboration with local, state, and federal public 
health partners utilizing the BioSense Platform, an electronic health 
information system.

Methods
DoD data was pulled from the BioSense Platform through a 

RStudio server on October 11, 2016, querying data from November 
1, 2015 to September 30, 2016. Appointment type and beneficiary 
category data was not available in BioSense until November 1, 2015. 
Appointment type was categorized into clinic visits and telephone 
consults. Demographic characteristics (age group, gender, beneficiary 
category) are stratified by appointment type.

Results
During the time period of November 1, 2015 to September 30, 2016, 

data were received from 452 clinics. There is a military treatment 
facility located in 45 states and a military treatment facility may 
have one to 12 clinics. There were a total of 86,840,632 healthcare 
encounter records. The age group, 25-44 years, accounted for 39.4% 
of the medical encounters; the mean age was 33.9 (SD=19.1). Males 
accounted for 55.6% of the medical encounters. For the time period 
from November 1, 2015 to September 30, 2016, 78.9% of medical 
encounters were clinic visits. The remaining medical encounters 
were telephone consults. Of the clinic visits, 53.7% of the medical 
encounters were for active duty personnel.

Conclusions
This report highlights the DoD data available to NSSP users for 

collaborative syndromic surveillance efforts, promoting a community 
of practice. It is important to understand the population demographics 
and limitations to the DoD data when conducting syndromic 
surveillance.

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 9(1):e166, 2017 



ISDS Annual Conference Proceedings 2017. This is an Open Access article distributed under the terms of the Creative Commons Attribution-
Noncommercial 3.0 Unported License (http://creativecommons.org/licenses/by-nc/3.0/), permitting all non-commercial use, distribution,  
and reproduction in any medium, provided the original work is properly cited.

ISDS 2016 Conference Abstracts

Figure 1. Heat map of counts of clinic visits by state, November 1, 2015 - 
September 30, 2016

Keywords
syndromic surveillance; NSSP; DoD; demographics

Acknowledgments
The authors thank Mike Schoelen for producing the map and Devin Hunt 
for SAS coding assistance.

*Jessica F. Deerin
E-mail: jessica.deerin@gmail.com

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 9(1):e166, 2017 


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