Expansion of ESSENCE for Use in Joint Military and Civilian Surveillance in Nine Cities

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Expansion of ESSENCE for Use in Joint Military and Civilian Surveillance in Nine Cities*

Nicola Marsden-Haug,¹ J. Pavlin,¹ V. Foster,^1,2 S. Rechter,¹ J. Lombardo,² S. Lewis^2

1Walter Reed Army Institute of Research, Silver Spring, Maryland; ²Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland

Corresponding author: Nicola Marsden-Haug, Nicola Marsden-Haug, Walter Reed Army Institute of Research, Division of Preventive Medicine, 503 Robert Grant Avenue, Silver Spring, MD 20190. Telephone: 301-319-7355; Fax: 301-319-9104; E-mail: nicola.marsden-haug@na.amedd.army.mil

Abstract

Introduction: Syndromic surveillance systems are increasingly commonplace, as multiple states and CDC have begun using them for potentially timelier and more sensitive outbreak detection. Although different nontraditional indicators are being used to achieve earlier detection, optimally sensitive systems should capture data from civilian, military, and veteran populations.

Objectives: Walter Reed Army Institute of Research and Johns Hopkins University Applied Physics Laboratory are participating in the U.S. Department of Defense Joint Services Installation Pilot Project (JSIPP). This project targets nine military installations as model sites for integrated surveillance, protection, and response. Under the force-protection component, sites will acquire chemical and biologic detection capabilities and emergency-response equipment. Sites will also receive an upgraded version of the Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE IV).

Methods: ESSENCE IV was developed for pilot testing at JSIPP sites. Military outpatient and prescription data will be integrated with civilian International Classification of Diseases, Ninth Revision (ICD-9) claims, emergency department chief complaints, and outpatient Veterans Affairs data from surrounding communities. Other enhancements include a new user interface, a geographic information system for mapping disease distribution and spatial clusters, and new temporal signal detection methods.

Results: The challenge of integrating military and civilian data is engaging appropriate personnel from both jurisdictions. For JSIPP, military preventive medicine and civilian public health will jointly define data-sharing agreements and standard operating procedures. Workshops will be held to establish alert-response protocols.

Conclusions: This program can serve as an example for establishing joint surveillance across military and civilian borders.

* The views expressed are those of the authors and do not reflect the position of the U.S Army or the U.S. Department of Defense.

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