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Telehealth Ontario Detection of Gastrointestinal Illness Outbreaks

  • Quantitative Research
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Canadian Journal of Public Health Aims and scope Submit manuscript

Abstract

Objective: Prompt detection of infectious disease outbreaks and rapid introduction of mitigation strategies is a primary concern for public health, emergency and security management organizations. Traditional surveillance methods rely on astute clinical detection and reporting of disease or laboratory confirmation. Although effective, these methods are slow, dependent on physician compliance and delay timely, effective intervention. To address these issues, syndromic surveillance programs have been integrated into the health care system at the earliest points of access; in Ontario, these points are primary care providers, emergency departments (ED), and Telehealth Ontario. This study explores the role of Telehealth Ontario, a telephone helpline, as an early warning system for detection of gastrointestinal (GI) illness.

Methods: Retrospective time-series analysis of the National Ambulatory Care Reporting System (NACRS) ED discharges and Telehealth Ontario data for GI illness from June 1, 2004 to March 31, 2006.

Results: Telehealth Ontario recorded 184,904 calls and the NACRS registered 34,499 ED visits for GI illness. The Spearman rank correlation coefficient was calculated to be 0.90 (p<0.0001). Time-series analysis resulted in significant correlation at lag (weekly) 0 indicating that increases in Telehealth Ontario call volume correlate with increases in NACRS data for GI illness.

Conclusion: Telehealth Ontario call volume fluctuation reflects directly on ED GI visit data on a provincial basis. Telehealth Ontario GI call complaints are a timely, novel and representative data stream that shows promise for integration into a real-time syndromic surveillance system for detection of unexpected events.

Résumé

Objectifs: La détection précoce d’épidémies de maladies infectieuses et l’introduction rapide de stratégies d’atténuation représentent une préoccupation de premier plan pour les organismes de santé publique, de secours et de gestion de la sécurité. Les méthodes de surveillance traditionnelles s’appuient sur la détection clinique et le signalement astucieux de maladies ou sur leur confirmation en laboratoire. Même si ces méthodes sont efficaces, elles sont lentes, dépendent du bon vouloir du médecin et retardent l’intervention efficace et opportune. Pour aborder ces questions, les programmes de surveillance syndromique ont été intégrés aux systèmes de soins de santé dans les premiers points d’accès. En Ontario, ces points sont les fournisseurs de soins primaires, le service des urgences et Télésanté Ontario. Dans cette étude, nous explorons le rôle de Télésanté Ontario, une ligne d’aide téléphonique, comme système d’avertissement précoce pour la détection des maladies gastro-intestinales (GI).

Méthodes: Nous avons effectué une analyse rétrospective des séries chronologiques des congés du service des urgences du Système national d’information sur les soins ambulatoires (SNISA) et des données de Télésanté Ontario sur les maladies GI, du 1er juin 2004 au 31 mars 2006.

Résultats: Télésanté Ontario a enregistré 184 904 appels et le SNISA a reçu 34 499 visites aux urgences concernant les maladies GI. Nous avons calculé le coefficient de corrélation de rang à 0,90 (p<0,0001). L’analyse de séries chronologiques a donné lieu à une corrélation importante au point 0 (hebdomadaire), indiquant que les augmentations du volume d’appels à Télésanté Ontario sont en corrélation avec celles des données du SNISA concernant les maladies GI.

Conclusion: Les fluctuations du volume d’appels à Télésanté Ontario reflètent directement les données sur les visites aux urgences à l’échelon provincial concernant les maladies GI. Les appels concernant les maladies GI effectués auprès de Télésanté Ontario représentent un filon de données représentatif, nouveau et opportun qui laisse entrevoir l’avenir d’un bon œil en ce qui concerne leur intégration dans un système de surveillance syndromique en temps réel pour la détection d’événements inattendus.

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Author information

Authors and Affiliations

  1. Department of Emergency Medicine, Queen’s University, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada

    Jaelyn M. Caudle MD & Kieran M. Moore MD

  2. Queen’s University Emergency Syndromic Surveillance Team, KFL&A Public Health, Kingston, ON, Canada

    Adam van Dijk MSc, Elizabeth Rolland MSc & Kieran M. Moore MD

Authors
  1. Jaelyn M. Caudle MD
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  2. Adam van Dijk MSc
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  3. Elizabeth Rolland MSc
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  4. Kieran M. Moore MD
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Corresponding author

Correspondence to Jaelyn M. Caudle MD.

Additional information

Acknowledgements: This study was supported by PSI Foundation Grant No. 05- 38 (K. Moore) and CIHR Doctoral Fellowship (E. Rolland). The study was presented as a poster at the Canadian Association of Emergency Physicians annual meeting, June 10, 2008 in Ottawa, ON.

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Caudle, J.M., van Dijk, A., Rolland, E. et al. Telehealth Ontario Detection of Gastrointestinal Illness Outbreaks. Can J Public Health 100, 253–257 (2009). https://doi.org/10.1007/BF03403942

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