How Making EDSS and IIS Interoperable Is Key to Fighting Future Outbreaks
The COVID-19 pandemic stretched public health departments across the country to the breaking point. They faced a deadly and mysterious disease from the beginning and did all they could to track and mitigate the spread. They learned difficult lessons but rose to the challenge to keep citizens safe and prevent a collapse of the healthcare system. During these unprecedented times, departments relied on data like never before to spot areas that could become potential hotspots or see how effective protocols were.
As this health crisis enters a new phase, many agencies are looking at areas where their response could have been better. One area facing much scrutiny is the lack of integration between systems, especially those used to track diseases and record immunizations. In most states, these are two separate departments using two separate computer systems like an Electronic Disease Surveillance System (EDSS) or Immunization Information System (IIS).
As one might imagine, EDSS helps public health agencies collect and report data on infectious diseases, not just COVID. It can track everything from STIs to measles outbreaks and report it to the Centers for Disease Control and Prevention (CDC). Using data from the EDSS can pinpoint disease clusters and help allocate resources to hot spots. IIS systems track who has received necessary vaccinations ranging from hepatitis and tetanus to Diphtheria plus the COVID vaccines and boosters.
However, because disease surveillance and immunization were two separate teams, sharing data became difficult and tedious. The focus now is on integrating these two systems, so the dissemination of information is more accessible and valuable. Integration has three significant benefits: an easier way to track vaccine efficacy, detect local cluster outbreaks, and produce better outcomes.
Interoperability helps track vaccine efficacy
COVID-19 saw the creation of multiple vaccines in record time. In less than a year from the first reported cases in North America, there were offerings from Pfizer–BioNTech, Moderna, and Johnson & Johnson. Two additional vaccines, Covaxin and Novavax, are awaiting regulatory approval. With this variety of options, it can be beneficial to see how the vaccines are doing in a real-world setting.
Despite a massive inoculation push, there were numerous breakthrough COVID infections across the country and around the world. However, it would be helpful for medical leaders to know these positive rates. With an interoperable EDSS and IIS system, it would be easy to track patients who became infected and cross-reference them to see their vaccination status. The system could show which vaccination they received and when they got it. This information helps scientists know how strong the protection is against COVID and its variants and how quickly it wanes over time.
This type of public health data is very useful for tracking the efficacy of other vaccines and diseases. For example, in 2019, before the pandemic-imposed lockdowns and social distancing, there were nearly 1,300 reported measles cases in the United States. Most were from people who were not vaccinated, but there were several breakthrough cases where protection might have waned. A better understanding of how long the vaccine protects people could change the recommendations and see booster shots administered to adults.
Interoperability helps identify local cluster outbreaks
The nature of the COVID-19 pandemic saw multiple waves of infection. When one wave crested, many jurisdictions relaxed protocols, leading to new infection clusters. EDSS can identify these clusters at a very early onset. If they can share the data with the IIS team, it can quickly respond and allocate resources to the areas with the most need for vaccination.
The IIS team could use several methods to help mitigate the spread of the virus. It could set up mass vaccination clinics in the area where the cluster appeared. It can step up communications to the area, advising people to get vaccinated, wear masks, and continue with hand hygiene practices. And, maybe even more importantly, tell people to stay home if they have any symptoms related to the virus.
This has broader implications than with just COVID. Public health departments can use virtually any infectious disease for it, from Monkeypox and influenza to STIs and the mumps. But, the earlier the IIS team gets this data from EDSS, the more targeted they can be in their strategies and prevent outbreaks that overwhelm the local hospital systems.
Interoperability produces better outcomes
As we’ve seen, allowing the EDSS and the IIS systems to communicate has a massive upside. It will enable public health departments to move swiftly and efficiently to mitigate the risks that transmissible diseases will wreak havoc on a community or state. It will also allow these health units to focus on areas with the greatest need and not rely on a scattershot approach.
In situations like this, speed is critical. Early in the COVID pandemic, it could take weeks for these two teams to share data. These delays were not done out of spite or malice but through an inability to present it in a usable format. Sometimes the various teams shared the data via a fax or handwritten pages of notes. Having interoperability between these systems will prevent this from happening in the future. And while integration will not always be easy, the benefits drastically outweigh the cost or complexity.