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Using Electronic Health Records (EHR) for Disease Surveillance (EHR-DS) to Support UN SDGs
Abstract
The spread of disease is a significant threat to the health and safety of all global citizens. Recent events show that disease migration is a never-ending struggle for the international community. In December 2019, the global community came face-to-face with another deadly, persistent, and resilient threat: the Coronavirus disease 2019 (COVID-19). COVID-19 is caused by the SARS-CoV-2 novel coronavirus. COVID-19 is multicultural, multiethnic, multilingual, and has no geopolitical, religious, socio-economic, or cultural bias. While man insatiably looks for ways to elevate himself above others who may not look like him, segregate himself from those who earn less than him, or marginalize those less fortunate than him, COVID-19 is on World tour, like a sadistic music band. All are welcome; regardless of ethnicity, religion, or economic status, admission is free. The United Nations, the World Health Organization (WHO), the American Centers for Disease Control and Prevention, the British National Health Service, the Ministry of Health of the Russian Federal, the Chinese Center for Disease and Prevention, and the French Santé publique France and other public and global health organizations worked tirelessly; collaborating, sharing data and resources to slow the spread COVID-19 to create and distribute vaccines. The collaboration was adequate but reactionary; it was too late for some. COVID-19 has killed over 6 million people globally. Although the convergence of data in the global health community was effective, it was reactionary, contact tracing was difficult, and frontline health providers and non-clinical workers were not prepared. However, making computational convergence a priority in global healthcare in the United Nations Agenda 30 Sustainment Development Goals (SDG) will prepare and empower global health organizations to take appropriate and timely steps, not if but when the next pandemic arrives.
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Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a new strain of virus in the Coronavirus family that has not been previously identified. Since SARS-CoV-2 is a new virus, everyone is at risk of catching the Coronavirus disease 2019 (Covid-19). No one has immunity to the virus. Despite this, misconceptions about specific groups of people who are immune to Covid-19 emerged with the onset of the pandemic. This paper explores South African communities’ misconceptions about who is most vulnerable to Covid-19. A rapid qualitative assessment was conducted remotely in Gauteng, KwaZulu-Natal and the Western Cape provinces of South Africa. Recruitment of study participants took place through established relationships with civil society organizations and contacts made by researchers. In total, 60 key informant interviews and one focus group discussion was conducted. Atlas.ti.8 Windows was used to facilitate qualitative data analysis. The qualitative data was coded, and thematic analysis used to identify themes. The results show a high level of awareness and knowledge of the transmission and prevention of SARS-CoV-2. Qualitative data revealed that there is awareness of elderly people and those with immunocompromised conditions being more vulnerable to catching Covid-19. However, misconceptions of being protected against the virus or having low or no risk were also evident in the data. We found that false information circulated on social media not only instigated confusion, fear and panic, but also contributed to the construction of misconceptions, othering and stigmatizing responses to Covid-19. The study findings bring attention to the importance of developing communication materials adapted to specific communities to help reduce misconceptions, othering and stigmatization around Covid-19.
Most humans are in contact with animals in a way or another. A zoonotic disease is a disease or infection that can be transmitted naturally from vertebrate animals to humans or from humans to vertebrate animals. More than 60% of human pathogens are zoonotic in origin. This includes a wide variety of bacteria, viruses, fungi, protozoa, parasites, and other pathogens. Factors such as climate change, urbanization, animal migration and trade, travel and tourism, vector biology, anthropogenic factors, and natural factors have greatly influenced the emergence, re-emergence, distribution, and patterns of zoonoses. As time goes on, there are more emerging and re-emerging zoonotic diseases. In this review, we reviewed the etiology of major zoonotic diseases, their impact on human health, and control measures for better management. We also highlighted COVID-19, a newly emerging zoonotic disease of likely bat origin that has affected millions of humans along with devastating global consequences. The implementation of One Health measures is highly recommended for the effective prevention and control of possible zoonosis.
On 25 September, 2015, world leaders met at the United Nations in New York, where they adopted the Sustainable Development Goals. These 17 goals and 169 targets set out an agenda for sustainable development for all nations that embraces economic growth, social inclusion, and environmental protection. Now, the agenda moves from agreeing the goals to implementing and ultimately achieving them. Across the goals, 42 targets focus on means of implementation, and the final goal, Goal 17, is entirely devoted to means of implementation. However, these implementation targets are largely silent about interlinkages and interdependencies among goals. This leaves open the possibility of perverse outcomes and unrealised synergies. We demonstrate that there must be greater attention on interlinkages in three areas: across sectors (e.g., finance, agriculture, energy, and transport), across societal actors (local authorities, government agencies, private sector, and civil society), and between and among low, medium and high income countries. Drawing on a global sustainability science and practice perspective, we provide seven recommendations to improve these interlinkages at both global and national levels, in relation to the UN’s categories of means of implementation: finance, technology, capacity building, trade, policy coherence, partnerships, and, finally, data, monitoring and accountability.
Electronic supplementary material
The online version of this article (doi:10.1007/s11625-016-0383-3) contains supplementary material, which is available to authorized users.
Objective:
Disease surveillance systems are expanding using electronic health records (EHRs). However, there are many challenges in this regard. In the present study, the solutions and challenges of implementing EHR-based disease surveillance systems (EHR-DS) have been reviewed.
Materials and methods:
We searched the related keywords in ProQuest, PubMed, Web of Science, Cochrane Library, Embase, and Scopus. Then, we assessed and selected articles using the inclusion and exclusion criteria and, finally, classified the identified solutions and challenges.
Results:
Finally, 50 studies were included, and 52 unique solutions and 47 challenges were organized into 6 main themes (policy and regulatory, technical, management, standardization, financial, and data quality). The results indicate that due to the multifaceted nature of the challenges, the implementation of EHR-DS is not low cost and easy to implement and requires a variety of interventions. On the one hand, the most common challenges include the need to invest significant time and resources; the poor data quality in EHRs; difficulty in analyzing, cleaning, and accessing unstructured data; data privacy and security; and the lack of interoperability standards. On the other hand, the most common solutions are the use of natural language processing and machine learning algorithms for unstructured data; the use of appropriate technical solutions for data retrieval, extraction, identification, and visualization; the collaboration of health and clinical departments to access data; standardizing EHR content for public health; and using a unique health identifier for individuals.
Conclusions:
EHR systems have an important role in modernizing disease surveillance systems. However, there are many problems and challenges facing the development and implementation of EHR-DS that need to be appropriately addressed.
Since its implementation after the 9/11 attack on the World Trade Center, the Customs Trade Partnership Against Terrorism
(C-TPAT) has grown to be one of the largest public/private partnerships in the world. The focus of C-TPAT is on the United
States’ vulnerability to the smuggling of weapons of mass destruction (WMD) across its borders. As a system, C-TPAT has achieved
great success; however, there remain a number of serious deficiencies that C-TPAT, by itself, cannot overcome. Very few cargo
containers are currently being inspected by Customs and Border Protection (CBP). This is due to lack of funding and manpower
deficiencies as well as the practical need to allow the flow of trade to continue as swiftly as possible. Instead of mass
inspection of containers, CBP relies on its ability to identify and further question or inspect “high risk” containers before
they are shipped or prior to their entry to the United States. Identifying “high risk” containers results in a far lower number
of CBP inspections, thereby offering less interference with the trade process. It is well known amongst shipping experts that
the contents of many containers are mislabeled or misdeclared. Combine the fact that many cargo containers contain misdeclared
contents with the current model of inspecting very few containers and one can conclude that the potential for problems is
enormous. Furthermore, concerns over specificity of standards related to C-TPAT security requirements and the likelihood that
membership in C-TPAT increases an organization’s potential for attack and the situation continues to deteriorate. C-TPAT began
as and remains an initiative with honorable goals; however, we cannot rely upon increasing numbers of C-TPAT members as a
measure of its effectiveness.
Livestock are a global resource of significant benefits to society in the form of food, income, nutrients, employment, insurance, traction, clothing and others. In the process of providing these benefits, livestock can use a significant amount of land, nutrients, feed, water and other resources and generate 18% of anthropogenic global greenhouse gases. The total demand for livestock products might almost double by 2050, mostly in the developing world owing to increases in population density, urbanization and increased incomes. Multiple existing trade-offs and competing demands for natural resources will intensify, but reducing livestock product demand in places and capitalizing on the positive aspects of livestock systems such as the potential for sustainable intensification of mixed systems, the potential of ecosystems services payments in rangeland systems and well-regulated industrial livestock production might help achieve the goals of balancing livestock production, livelihoods and environmental protection.
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