Department of Emergency Medicine, Wayne State University, Detroit, MI, USA.
Newton Massachusetts, Newton, MA, USA.
BMC Med Inform Decis Mak. 2023 Oct 17;23(1):224. doi: 10.1186/s12911-023-02310-4.
For surveillance of episodic illness, the emergency department (ED) represents one of the largest interfaces for generalizable data about segments of the US public experiencing a need for unscheduled care. This protocol manuscript describes the development and operation of a national network linking symptom, clinical, laboratory and disposition data that provides a public database dedicated to the surveillance of acute respiratory infections (ARIs) in EDs.
The Respiratory Virus Laboratory Emergency Department Network Surveillance (RESP-LENS) network includes 26 academic investigators, from 24 sites, with 91 hospitals, and the Centers for Disease Control and Prevention (CDC) to survey viral infections. All data originate from electronic medical records (EMRs) accessed by structured query language (SQL) coding. Each Tuesday, data are imported into the standard data form for ARI visits that occurred the prior week (termed the index file); outcomes at 30 days and ED volume are also recorded. Up to 325 data fields can be populated for each case. Data are transferred from sites into an encrypted Google Cloud Platform, then programmatically checked for compliance, parsed, and aggregated into a central database housed on a second cloud platform prior to transfer to CDC.
As of August, 2023, the network has reported data on over 870,000 ARI cases selected from approximately 5.2 million ED encounters. Post-contracting challenges to network execution have included local shifts in testing policies and platforms, delays in ICD-10 coding to detect ARI cases, and site-level personnel turnover. The network is addressing these challenges and is poised to begin streaming weekly data for dissemination.
The RESP-LENS network provides a weekly updated database that is a public health resource to survey the epidemiology, viral causes, and outcomes of ED patients with acute respiratory infections.
对于偶发性疾病的监测，急诊科（ED）是美国公众中需要非计划性护理的人群中关于通用数据的最大接口之一。本方案手稿描述了一个国家网络的开发和运作，该网络将症状、临床、实验室和处置数据联系起来，为监测急诊科急性呼吸道感染（ARI）提供了一个公共数据库。
呼吸道病毒实验室急诊科网络监测（RESP-LENS）网络包括 26 名学术调查员，来自 24 个地点，与 91 家医院和疾病控制与预防中心（CDC）合作进行病毒感染调查。所有数据均源自通过结构化查询语言（SQL）编码访问的电子病历（EMR）。每周二，数据将被导入前一周发生的 ARI 就诊的标准数据表（称为索引文件）；还记录了 30 天的结果和 ED 量。每个病例最多可填充 325 个数据字段。数据从站点传输到加密的谷歌云平台，然后通过编程检查其合规性，解析，并在转移到 CDC 之前聚合到中央数据库中。
截至 2023 年 8 月，该网络已经报告了超过 87 万例 ARI 病例的数据，这些病例是从大约 520 万例 ED 就诊中选择的。网络执行方面的合同后挑战包括本地检测政策和平台的变化、ICD-10 编码延迟以检测 ARI 病例，以及站点层面的人员流动。该网络正在应对这些挑战，并准备开始每周流式传输数据进行传播。
RESP-LENS 网络提供了一个每周更新的数据库，是一个公共卫生资源，用于调查急诊科急性呼吸道感染患者的流行病学、病毒原因和结果。
