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Can Telehealth Ontario respiratory call volume be used as a proxy for emergency department respiratory visit surveillance by public health?

Published online by Cambridge University Press:  21 May 2015

Adam van Dijk ,
Don McGuinness ,
Elizabeth Rolland  and
Kieran M. Moore
Adam van Dijk*
Affiliation:
Queen's University Emergency Syndromic Surveillance Team (QUESST), Kingston, Ont.
Don McGuinness
Affiliation:
Queen's University Emergency Syndromic Surveillance Team (QUESST), Kingston, Ont.
Elizabeth Rolland
Affiliation:
Queen's University Emergency Syndromic Surveillance Team (QUESST), Kingston, Ont. Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, London, UK
Kieran M. Moore
Affiliation:
Queen's University Emergency Syndromic Surveillance Team (QUESST), Kingston, Ont. Department of Emergency Medicine and Community Health and Epidemiology, Queen's University, Kingston, Ont.
*
Syndromic Surveillance KFL&A Public Health, 221 Portsmouth Ave., Kingston ON K7M 1V5; [email protected]

Abstract

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Objective:

There is a paucity of information regarding the usefulness of non-traditional data streams for real-time syndromic surveillance systems. The objective of this paper is to examine the temporal relation between Ontario's emergency department (ED) visits and telephone health line (Telehealth) call volume for respiratory illnesses to test the feasibility of using Ontario's Telehealth system for real-time surveillance.

Methods:

Retrospective time-series data from the National Ambulatory Care Reporting System (NACRS) and the Telehealth Ontario program from June 1, 2004, to March 31, 2006, were analyzed. The added value of Telehealth Ontario data was determined by comparing it temporally with NACRS data, which uses the International Classification of Diseases (ICD) 10-Canadian Enhancement coding system for discharge diagnoses.

Results:

Telehealth Ontario had 216 105 calls for respiratory complaints, while 819 832 ICD-coded complaints from NACRS were identified with a comparable diagnosis of respiratory illness. Telehealth Ontario call volume was heavily weighted for the 0–4 years age group (49%), while the NACRS visits were mainly from those 18–64 years old (44%). The Spearman rank correlation coefficient was calculated to be 0.97, with the time-series analysis also resulting in significant correlations at lags (semi-monthly) 0 and 1, indicating that increases in Telehealth Ontario call volume correlate with increases in NACRS discharge diagnosis data for respiratory illnesses.

Conclusion:

Telehealth Ontario call volume fluctuation reflects directly on ED respiratory visit data on a provincial basis. These call complaints are a timely, useful and representative data stream that shows promise for integration into a real-time syndromic surveillance system.

Résumé

RÉSUMÉObjectifs:

Il y a une insuffisance d'information concernant l'utilité de flux de données non conventionnels pour les systèmes de surveillance syndromique en temps réel. Cet article vise à examiner la relation temporelle entre les visites aux salles d'urgence en Ontario et le volume d'appels au service téléphonique de conseils-santé Télésanté Ontario concernant des troubles respiratoires afin de mesurer la faisabilité d'utiliser Télésanté Ontario aux fins de surveillance en temps réel.

Méthodes:

Nous avons fait une analyse rétrospective d'une série chronologique de données provenant du Système national d'information sur les soins ambulatoires (SNISA) et de Télésanté Ontario couvrant la période du 1er juin 2004 au 31 mars 2006. La valeur ajoutée des données de Télésanté Ontario a été déterminée en comparant ces données temporellement à celles du SNISA, qui utilise le système de codification de la version élargie (CIM-10-CA) de la Classification internationale des maladies (CIM-10), pour les diagnostics de congé.

Résultats:

Télésanté Ontario a reçu 216 105 appels relatifs à des troubles respiratoires alors que 819 832 plaintes codées selon la CIM du SNISA portaient un diagnostic comparable d'une maladie respiratoire. Le volume d'appels de Télésanté Ontario était nettement plus élevé pour le groupe des 0 à 4 ans (49 %), alors que les visites consignées dans le SNISA étaient principalement du groupe des 18 à 64 ans (44 %). Le coefficient de corrélation de Spearman était de 0,97, et les analyses de série chronologique ont montré des corrélations significatives dans l'intervalle (bimensuel) 0 et 1. Cela signifie qu'il y a une corrélation entre la hausse du volume d'appels à Télésanté Ontario et la hausse des données de diagnostics de congé du SNISA relatives aux maladies respiratoires.

Conclusion:

Les fluctuations du volume d'appels à Télésanté Ontario ont des répercussions directes sur les données relatives aux visites à l'urgence pour des troubles respiratoires à l'échelle provinciale. Ces appels constituent un flux de données représentatif, ponctuel et utile, qui est prometteur pour son intégration dans un système de surveillance syndromique en temps réel.

Keywords

telehealthsyndromic surveillancerespiratory illnesspublic health
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 10 , Issue 1 , January 2008 , pp. 18 - 24
Copyright
Copyright © Canadian Association of Emergency Physicians 2008

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