Research Paper on Canadian Surveillance Systems

Introduction

The first surveillance system that I selected for this assignment is known as Canadian Acute Flaccid Paralysis Surveillance System (CAFPSS). In Canada, the collaboration between the Canadian Pediatric Society and the Public Health Agency of Canada has ensured successful surveillance of acute flaccid paralysis, AFP (Government of Canada, 2014). AFP is described as the sudden onset of paralysis or muscle weakness. The CAFPSS is conducted in children aged 15 years and below. The muscle weakness is usually termed as flaccid suggesting the presence of a reduced tone in the with no other apparent cause for the condition. When undertaking AFP diagnosis, weakness lasting for a short duration should not be part of the diagnosis (Government of Canada, 2014b).

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The primary importance of CASPSS is monitoring of Canada's polio-free status by making sure that there is a sensitive, active, and prompt surveillance system which can guarantee proper investigation of AFP cases thus ruling out the likelihood of poliovirus infection. All the reported cases of the disease undergo a thorough review with the aim of determining compatibility with national surveillance descriptions of paralytic poliomyelitis. The data supplied by physicians and nurses involved in monitoring are essential in the adjudication process (Government of Canada, 2014b).

The second surveillance system that I chose for this assignment is referred to as the Canadian Chronic Disease Surveillance System, CCDSS. In CCDSS, linked administrative data sources derived from each of the provinces and territories of Canada are used in the estimation of the prevalence and incidence of chronic conditions. Additionally, the same data are used to estimate mortality attributed to all causes among Canadians with chronic diseases and those without the chronic illness. Data derived from CCDSS can be classified based on the province or territory, age groups, sex, and age. The CCDSS is aimed at fostering a collection of surveillance information with consistency and comparability across jurisdictions. CCDSS ensures that patients' privacy is maintained because the only data that is shared by territories and provinces is aggregated data. Monitoring of chronic illnesses using CCDSS technique supports other surveillance information sources, e.g., registries and surveys and helps in ensuring that there is timely reporting of disease data thus supporting the planning and evaluation of policies and programs.

Description of How EHRs are Used in CAFPSS and CCDSS

The electronic health records collected by CAFPSS are used in the detection of polio activity with the data collected being reported on the basis of three quality assurance indicators. First, the electronic health records are used to detect more than 1 nonpolio AFP cases per 100,000 kids under 15 years of age every year. Consequently, it can be concluded that CAFPSS data form the basis of determining the prevalence of polio. Secondly, the detection of poliovirus is carried out by analyzing a stool sample collected within 14 days of the onset of paralysis. Thirdly, the residual analysis is documented through a follow-up examination 60 days after the start of paralysis (Rotondo, Desai, Pless, Ahmad, Squires, & Booth, 2015).

The CCDSS was developed by the Public Health Agency of Canada in 2009 with the aim of facilitating the standardized, national estimation of the prevalence of chronic disease, health outcomes, and incidence (Pelletier et al., 2018; Reimer & Lix, 2017). The sources of CCDSS electronic health records include hospital discharge abstracts, physician billing claims, and linked health insurance registration files. The health insurance registration files capture data of all the residents with eligibility for territorial or provincial health insurance, about 97% of the residents.

The primary similarities of how EHRs are used in CAFPSS and CCDSS is that in both surveillance systems, EHRs forms a basis for estimation of the prevalence of the disease. However, the difference between CAFPSS and CCDSS is that CAFPSS is not used to estimate outcomes and incidence. Additionally, unlike CAFPSS which is only used for surveillance of poliovirus, CCDSS is used in monitoring various chronic diseases.

Analysis of Potential Challenges and Opportunities for Using EHRs in the United States

One of the challenges of using the EHRs in the United States is delayed collection of data. This is because Canada and the United States employ different healthcare systems. Specifically, unlike Canada which uses the universal healthcare system (Martin et al., 2018) while the United States utilizes the state healthcare system. Consequently, a collection of healthcare data in the United States would be more likely to be slower than in Canada. However, some of the opportunities which are available in the United States is the likelihood of having an advanced web-based surveillance system (Choi, Cho, Shim, & Woo, 2016).

Recommendations for Addressing the Challenges

One of the ways of addressing the delayed gathering of electronic health data that is associated with the absence of a universal healthcare system in the United States is by using real-time surveillance of diseases (Aziz, 2017; Groseclose & Buckeridge, 2017). According to Jian, Chen, Lee, and Liu (2017), real-time surveillance can be achieved through integrated multiple surveillance systems with a capacity of nationwide presence. It is also important for clinical laboratories and hospitals to use automated reporting mechanisms to enhance the timely reporting of health data (Jian et al., 2017).

References

Aziz, H. A. (2017). A review of the role of public health informatics in healthcare. Journal of Taibah University Medical Sciences, 12(1), 78-81. https://doi.org/10.1016/j.jtumed.2016.08.011

Choi, J., Cho, Y., Shim, E., & Woo, H. (2016). Web-based infectious disease surveillance systems and public health perspectives: a systematic review. BMC Public Health, 16(1), 1238. https://doi.org/10.1186/s12889-016-3893-0

Government of Canada (2014a). Surveillance of acute flaccid paralysis. Retrieved from https://www.canada.ca/en/public-health/services/surveillance/acute-flaccid-paralysis.html

Government of Canada (2014b). Public Health Surveillance. Retrieved from https://www.canada.ca/en/public-health/services/surveillance.html#a2

Groseclose, S. L., & Buckeridge, D. L. (2017). Public health surveillance systems: recent advances in their use and evaluation. Annual Review of Public Health, 38(1), 57-79. https://doi.org/10.1146/annurev-publhealth-031816-044348

Jian, S.-W., Chen, C.-M., Lee, C.-Y., & Liu, D.-P. (2017). Real-time surveillance of infectious diseases: taiwan's experience. Health Security, 15(2), 144-153. https://doi.org/10.1089/hs.2016.0107

Martin, D., Miller, A. P., Quesnel-Vallee, A., Caron, N. R., Vissandjee, B., & Marchildon, G. P. (2018). Canada's universal health-care system: achieving its potential. The Lancet, 391(10131), 1718-1735. https://doi.org/10.1016/S0140-6736(18)30181-8

Pelletier, L., Waits, S., VanTil, L., Tu, K., Svenson, L., Smith, M., ... Lix, L. (2018). The canadian chronic disease surveillance system: a model for collaborative surveillance. International Journal of Population Data Science, 3(3). https://doi.org/10.23889/ijpds.v3i3.433

Reimer, K., & Lix, L. (2017). The canadian chronic disease surveillance system: a distributed surveillance model. Online Journal of Public Health Informatics, 9(1). https://doi.org/10.5210/ojphi.v9i1.7726

Reimer, K., Lix, L. M., & Feely, A. (2017). Estimating multimorbidity prevalence with the canadian chronic disease surveillance system. Health Promotion and Chronic Disease Prevention in Canada : Research, Policy and Practice, 37(7), 215-222. https://doi.org/10.24095/hpcdp.37.7.02