Evaluating the application and utility of ESSENCE for early event detection
Authors: Kunerth Allison K. , Baker Elizabeth , Zelicoff Alan , Elliot Michael , Syberg Kevin 
Published: May 2017

ObjectiveA mixed methods study is being conducted on the statewide EarlyNotification of Community Based Epidemics (ESSENCE) systemin Missouri to identify factors that can improve the timeliness andidentification of outbreaks. This research will provide stakeholderswith guidance on how best to implement and improve ESSENCEusage statewide, and by sharing this research input can be solicitedon the utility of the applied framework as well as future implicationsfrom this body of work.IntroductionIn spite of the noted benefits of syndromic surveillance, andmore than a decade after it started gaining support, the primary usefor syndromic surveillance appears to be largely for seasonal andjurisdictional disease monitoring, event response and situationalawareness as opposed to its intended purpose of early event detection.(1-4) Research assessing the user characteristics and standards appliedat local public health agencies (LPHA’s) for syndromic surveillanceare scarce, and in national surveys epidemiologists frequently tendto utilize their own syndromic surveillance systems as opposed toa national system such as Biosense. While the National SyndromicSurveillance Program (NSSP) has addressed many operationalconcerns from stakeholders, and is in the process of providing accessto the cloud based Biosense platform-along with ESSENCE as a keytool, there is still a paucity of research that exists as to what can bedone to improve the utilization of syndromic surveillance systems forits primary purpose of early event detection.MethodsThis research proposes to evaluate the use of ESSENCE withinMissouri and the surrounding areas, to comprehensively identifyits strengths and limitations, through an assessment of the userexperience. This research will evaluate three key areas: 1) thequality of the data received by the syndromic surveillance system,2) the characteristics of the individuals and organizations utilizingthe system (end-users), 3) the influence and extent of syndromicsurveillance data on public health actions. ESSENCE data will beevaluated directly with special attention to the top three data qualityattributes across the literature, completeness, accuracy and timeliness.(5) A survey will also be administered to ESSENCE system users andpublic health leadership at LPHA’s, to gain insight into perspectives,perceptions and general practices, as well as how they interact withdata from ESSENCE.ResultsThe data for this research is primarily being collected throughoutthe fall of 2016, so the hope is to bring preliminary data to thisconference as a means to validate some of the findings, solicit inputon the proposed framework and share this research in a timely mannerfor the NSSP roll out of Biosense and ESSENCE.ConclusionsThrough a thorough evaluation, the application and utility ofESSENCE for early event detection will be better understood, alongwith the identification of factors that can be targeted in the future(and across syndromic surveillance platforms) for improvement in thetimely identification of outbreaks.