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Desiree Mustaquim Surveillance Epidemiologist Centers for … · 2017. 6. 16. · NACCHO, NAPHSIS....
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Cloud Computing – Federal Perspective Desiree Mustaquim Surveillance Epidemiologist Centers for Disease Control and Prevention – Influenza Division
Transcript of Desiree Mustaquim Surveillance Epidemiologist Centers for … · 2017. 6. 16. · NACCHO, NAPHSIS....
Cloud Computing – Federal PerspectiveDesiree Mustaquim
Surveillance Epidemiologist
Centers for Disease Control and Prevention – Influenza Division
Outline for this portion• Flu story
• HL7 messaging• NGS
• CDC• Challenges• CDC initiatives related to cloud
• AMD• SDP• Other exploration of cloud
The Flu Story: Brief Background
• New vaccine developed each year (for northern and southern hemispheres)
• Extensive surveillance system to support this and monitor influenza activity
The Flu Story: PHLIPPublic Health Lab Interoperability Project
• HL7 messaging of lab results• To CDC for Surveillance• State-to-state for Surge capacity
• Infrastructure challenges• Transport – needed assistance - RnR• Evolved into AIMS• AIMS became cloud-based
• Other programs now using this model• VPD-RC• Rabies –processed in cloud
General Message Flow
AIMS – now with more capabilities than just RnR
Current Influenza Laboratory Reporting Methods*
District of Columbia
PHLIPPHLIS2
*As of 4/2017
NYC
DoD
Houston
SLO Co.
NHRC
PHLIP Influenza: ELSM from PHLs to CDC
Influenza testing information and all results for ~80% of specimens tested in PHLs ~75,000 specimens/year). Used for a variety of purposes, including reagent monitoring, specimen submission monitoring, but mainly published each week in FluView and NREVSS.
Four reference centers• Wadsworth Center (NY State
Department of Health)• California Department of Public
Health • Wisconsin State Laboratory of
Hygiene• Minnesota Department of Health,
Public Health Laboratory• NYC submits data – not as an RC
Test for a variety of vaccine preventable pathogens – serving 52 state and county PHLs
• Started with measles, mumps, rubella, varicella, meningitis (S. pneumoniae, N. meningitidis, H. influenza) and B. pertussis
• Expanded to several others in subsequent years
• Developed to provide PHLs with access to reliable testing for these now rare pathogens without having to maintain proficiencies locally
Slide Credit: Linda Cohen, APHL, and Sang Kang, CDC
PHLIP Vaccine Preventable Disease Reference Centers
PHL /USDA-L
CDC-EPI
PHA
ProviderSpecimen / Test Order (paper)
Test Result (paper)
Bite
Rep
ort
(Ele
ctro
nic
/pap
er)
CDC-Lab
Sick animal
bite
Specimen / Test Order
(paper)
Test Result (paper)
AIMS
View /
Download
View /
Download
Rabies – Proposed dataflow/architecture
The Flu Story (cont.) Next Gen Sequencing
• Increased need in 2014-15 season• Drifted Influenza A(H3N2)• Severe flu season• Difficult to grow, decreasing ability to
perform HI testing• Infrastructure not able to support the
need for moving/storing data if this size• Answer = cloud/AIMS
CDC Initiatives around cloud
Challenges:• Security policy – still evolving• Costs/sustainability• Negotiating contracts• Evaluating best uses
Example projects:• Advanced Molecular Detection (AMD)• Surveillance needs• Routing data back to state and local partners
(and other partners)
AMD
Why cloud technology should be considered• Very large data sets• Need for storage• Need for data transport• AMD systems being built with cloud
*Please visit some of the sessions on AMD for more specific information on non-flu AMD projects
Surveillance Data PlatformNeed to Improve existing surveillance infrastructure
• Too many “siloed” systems• Need to update technology• Mandate from funders (Congress) and request
from partnersSurveillance Strategy: Lays out strategies for improving
surveillance, including:• Improving use/reuse of data• Taking advantage of new technology (like
cloud)• More cross-cutting initiatives
Presenter
Presentation Notes
Problems addressing: Existing Surveillance infrastructure – still evolv Too many separate, siloed systems New technology emerging (ex. Cloud) that can offer improvements Requests from partners and mandate from Congress: “develop a timeline for a cloud-based and flexible IT public health data reporting platform for CDC programs” Surveillance strategy Enhance accountability, resource use, work force and innovation in surveillance Accelerate the use of emerging tools for public health agility Cross-cutting initiatives to improve data availability, usability, and incorporate advanced IT solutions Key areas for improvement: electronic lab data, syndromic surveillance, electronic death reporting, electronic case reporting for notifiable diseases
Health Data Networks
Public Health Partners
Healthcare providers
Laboratories
State Territorial, Local, and Tribal State Agencies
CommunityPlatforms
(e.g. AIMS,PHCP,HIE)
Surveillance Data Platform
Shared Services
APHL, CSTE, ASTHO, NACCHO, NAPHSIS
OtherSources
CDCPublic Health
ProgramSystems
Definitions:- Shared Services are specific business, science and IT functions that are standardized
and built for reuse by multiple parts of an organization- AIMS is the Association of Public Health Labs Informatics Messaging Services- PHCP is the Public Health Community Platform- HIE is Health information Exchange
Shared Services
Collaboration Vision for Surveillance Data Flow
Presenter
Presentation Notes
Vision Exchange Data. Share Tools. Drive Public Health Action Mission Develop platform of services for internal and external partners that: Reduces unnecessary burden on internal and external partners Improves efficiency in data services Enhances the ability to collect, prepare, analyze, and share data Objectives Build a secure, cloud-based, integrated surveillance platform with modular capability Deploy shared services that enable surveillance programs to perform missions more efficiently and reduce partner burden
Other applications of cloud
• Exploring for routing of ELR from CDC• Emergency response uses• New ideas every day
Take-home points
• Use cloud when it makes sense – evaluation important
• Essential infrastructure for some of our current needs
