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ISDS 2018 Conference Abstracts

The RHINO Community of Practice: Building a Space 
for Data Users and Enthusiasts in Washington State
Amanda D. Morse*, Kevin Wickersham, Natasha Close, Elyse Kadokura and 
Tom E. Hulse
Office of Communicable Disease Epidemiology, Washington State Department of Health, Shoreline, WA, USA

Objective
To grow and facilitate a community of syndromic surveillance data 

users in Washington State, improving and expanding local syndromic 
practice.

Introduction
Prior to June 2016, there were 45 registered users of syndromic 

surveillance data in Washington State, with 29 (64.4%) representing 
5 of Washington’s 35 local health jurisdictions and 16 (35.6%) at 
the state level. Of those registered users, 9 (8.8%) had logged into 
ESSENCE at least once in the 6 months before October 2016.

In June 2016, the Washington State syndromic surveillance 
program began accepting Meaningful Use data and sought to increase 
its user base. To accomplish this, the Washington State Department 
of Health (WA DOH) designated a staff member to oversee outreach 
efforts to increase the visibility of syndromic data in the state, 
including the establishment of a Community of Practice.

Methods
The Washington State syndromic surveillance program—the 

Rapid Health Information NetwOrk (RHINO)—began the process 
of stakeholder engagement by delivering a needs assessment to 15 
current and potential users of the Electronic Surveillance System for 
the Early Notification of Community-based Epidemics (ESSENCE) 
platform. The survey assessed interest in participation in a Community 
of Practice for Washington State syndromic data users, the timing and 
format for meetings, needs for technical assistance, and topic areas of 
interest. RHINO then used the survey results to create a bank of topics 
for Community of Practice calls and develop a strategy for long-term 
outreach and engagement.

In April of 2017, the RHINO team developed a new strategic 
plan and outlined metrics for evaluating growth and challenges 
in the program’s outreach efforts, including plans for outreach 
to novel disciplines like emergency preparedness. These metrics 
included counts of invitations for speaking engagements, ESSENCE 
users, onsite ESSENCE trainings and attendees at those trainings, 
organizations and disciplines represented in the Community of 
Practice, Community members, and webinars facilitated for the 
Community. RHINO staff compiled monthly tabulations of these 
metrics to track progress over the course of the year and aid in 
adjustments to outreach efforts as necessary.

Results
RHINO received 10 responses to the survey, with 9 respondents 

from local health jurisdictions and 1 from WA DOH. Respondents 
indicated particularly strong interest in regular webinars, a database 
of resources, and live trainings to support syndromic practice in their 
work. They also expressed concerns about the distance which would 
be required for in-person meetings.

RHINO established that meetings would occur via webinar every 
other month and held 6 webinars between October 2016 and October 
2017 on a broad range of topics including developing syndrome 
definitions, basic ESSENCE functions, using ESSENCE’s Report 
Manager tool, monitoring influenza-like-illness in ESSENCE, and 

using syndromic data for situational surveillance. In addition to the 
Community of Practice webinars, RHINO staff developed technical 
guides for both the Washington and National Surveillance Program’s 
(NSSP) ESSENCE platforms, a handbook for using syndromic 
surveillance data in Washington State, and a curriculum for onsite 
ESSENCE training.

Between October 2016 and October 2017, RHINO offered 8 
onsite ESSENCE trainings for groups of users at the Washington 
State Department of Health and local health jurisdictions, serving a 
total of 36 attendees. Over the course of the year, ESSENCE users 
in Washington State increased to 75, with 40 (53.3%) of them 
logging into the system at least once over the previous 6 months 
and 20 (26.7%) listed as “new users” who have not yet activated 
their accounts. The Community of Practice itself has 86 members 
representing 16 agencies and 19 disciplines.

As RHINO’s profile increased and more potential users became 
aware of the availability of syndromic data, RHINO began receiving 
invitations to present for external partners. Between March 2016 and 
October 2017, RHINO received 8 invitations to present to audiences of 
potential syndromic data users. These audiences included leadership 
at the Washington State Department of Health and emergency 
preparedness and response organizations.

In the next year, the program will continue offering data trainings 
and partner meetings to better serve the needs of both current and 
potential data users in Washington State. As more jurisdictions begin 
to have production-quality data, RHINO will continue offering onsite 
training. RHINO has also built a relationship with the Northwest 
Tribal Epidemiology Center in Portland, Oregon to begin the process 
of exploring data sharing with the Tribal Nations and Organizations 
located within Washington.

Conclusions
Through the development and implementation of a detailed 

outreach plan, RHINO increased the user base and profile of 
syndromic surveillance data in Washington State. This work was 
made possible through the careful construction of strong relationships 
with new and potential partners and the decision to diversify RHINO’s 
staff to include members with backgrounds beyond epidemiology.

Keywords
community of practice; ESSENCE training; data user outreach

Acknowledgments
The authors would like to thank our partner organizations in Washington 
State and Oregon for their commitment to strengthening relationships and 
improving syndromic practice in our state and broader region. Particular 
gratitude is due to the Washington Traffic Safety Commission for funding 
RHINO’s outreach and legislative efforts.

*Amanda D. Morse
E-mail: amanda.morse@doh.wa.gov

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 10(1):e183, 2018