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Public Health Agency of Canada
Traveller Health Assessment Database
Standing on Guard for Public Health with Reliable Data
Challenge
The Public Health Agency of Canada is the federal agency responsible for all public health matters that are of concern to Canadians. It was formed in 2004 as a result of the SARS public-health crisis of the previous year. The agency's Quarantine Division plays an essential role in public health delivery and response because it is responsible for international entry and departure points in Canada. The Quarantine Service provides urgent assessment, management and follow-up of suspected cases of communicable diseases among air, land, and sea travellers.
Data is gathered from health assessments of ill travellers arriving or leaving from Vancouver, Calgary, Toronto, Ottawa, Montreal and Halifax. Until recently, however, data collected during assessments was performed through manual collection in paper-based files in the six quarantine stations across Canada. There was no timely national access to data, inconsistency in data quality and management practices, duplication of efforts and inconsistency in the storage and transmission of secure data.
There were no means of generating reports or statistical analyses, and no comprehensive data set for scientific evaluation of risk factors related to internationally arriving travellers.
Solution
The Traveller Health Assessment Database system uses information technology to rapidly collect, manage and report on clinical case information gathered by Quarantine Service officers.
The solution is a secure, pan-Canadian Web-based quarantine application built in Java that amalgamates traveller health reports from different ports of entry in Canada. Each quarantine officer enters assessment data on a Lenovo tablet PC by filling out an electronic form. This takes half the time of the previous paper version. The electronic form has data-quality checks built into it, so that missing, incorrect or incomplete data errors are flagged.
Every five minutes, an electronic agent on the quarantine officer's tablet PC pushes traveller health reports to a central repository at headquarters of the Public Health Agency of Canada in Ottawa, where they are automatically entered into the Oracle Enterprise database without human intervention.
Another automatic agent checks every few minutes for anomalies in the data coming in from the six sites. If certain symptoms are found or thresholds are breached, public-health alerts can be sent to medical teams and administrators' e-mail and BlackBerry devices. For instance, an administrator may want to be notified if more than five traveller health reports containing a particular symptom have been discovered in different parts of the country with flights originating from another part of the world.
The database gives public health officials a central repository that is accessible across the country by authorized users. Disease trends and transmission patterns can be better identified as more analysts have access to the data.
Results
The Traveller Health Assessment Database provides improvements to the quarantine officers' core business processes that will be critical in the case of an infectious disease outbreak. Potential outbreaks and health risks can now be identified and alerted within minutes of traveller health reports being submitted.
The solution has positioned Canada as a world leader in quarantine information collection, monitoring, management and traveller-related disease response. There is now a national, efficient, flexible, secure and comprehensive data management and analysis system for public-health action and response. It helps to meet the requirements of the new Canadian Quarantine Act proclaimed in December 2006.
The database system also gives Canada a cost-effective means to meet obligations under the World Health Organization's International Health Regulations through timely access to data collected from international travellers.
Innovative Use of Technology
The Traveller Health Assessment Database moves beyond the data storage and management capabilities of traditional databases. It is uniquely designed to blend the essential operational elements of the Quarantine Service with disease screening, administration, quality control and secure real-time case management.
The reporting application includes policy-management rules that permit users to govern how the application works - for example, sending out certain notices from the tablet PCs at set intervals to deal with a particular threat or developing situation. These policies are created, modified and deleted on the fly, without requiring an application to be recompiled or shut down and restarted.
Various reporting functions provide the chief quarantine officer of the Public Health Agency of Canada with real-time data on traveller health reports. Bar charts, pie charts and an assessment summary deliver time-sliced information, which is critical to the management of public health events.
The database solution was created by the Application and Architecture Design and Development Section within the Information Management/Information Technology Directorate of the Public Health Agency, which has designed a software architecture to build and support software for approximately 30 program areas in the agency. New components and services designed for the database solution can be reused for other program areas and future applications, reducing the future cost of public-health applications.
A 2007 CIPA Winner!
For its excellent application of information technology to transform processes and bring benefits to its stakeholders, the Public Health Agency of Canada has been awarded a CIPA Silver Award of Excellence in the Organizational Transformation, Not-For-Profit category.
Technology partners
Lenovo Group Limited
Oracle Corporation Canada Inc.
Research in Motion Limited
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