1. Partners in Sentinel Health Surveillance 2003-2004 TARRANT Annual Meeting February 24, 2005 Partners in Sentinel Health Surveillance 2003-2004 TARRANT Annual Meeting February 24, 2005 National Research System (NaReS) Staff Jamie Jensen - FluWatch Coordinator Anita Lambert-Lanning - Research Information Coordinator (NaReS)

2. LA / NaReS FluWatch Sentinel Provinces I http://www.hc-sc.gc.ca/pphb-dgspsp/fluwatch/index.html

3. Provided by Jeannette Macey 2002

4. NaReS FluWatch Recruitment Procedures Welcome packages faxed out in September Extra sentinels recruited (faxing recruitment packages / phone calling) in CDs as needed using expected rate of 1 sentinel per 250,000 population Recruitment process labour intensive in fall but now continues year round for new and replacement recruits

5. Sample Fluwatch Reporting Form See additional handout \\cfpcfile\cfpc\research\Anita\reporting form.pdf

6. April blip? holidays

8. Participation Rates by Province 2003-04 # of CDs/HRs # CDs/HRs filled % CDs / HRs filled by season end Peak # of sentinels # sentinels as of apr 2004 Manitoba 12975%1815 Ontario 493878%7169 Quebec 19737%1716 New Brunswick 7685%17 Nova Scotia 181478%17 NewFoundland / Labrador 10550%77 PEI 3266%33 TERR 6350%1514 TOTALs 1248467%165158

9. Data Collection Process Evaluation Surveys NaReS FluWatch Sentinels (n=158) were sent an Evaluation Questionnaire in Mar 2004 7 requested discontinuation throughout year French speaking sentinels received evaluation form in French if indicated Response Rates to Evaluation=138/158 (87%)

10. Evaluation of Participation # n=138 % Agree Amt of time spent completing Forms was < 15 minutes 10576.1 Amt of time required for participation was acceptable 13698.6 Instructions clear & easy to follow 138100.0 Weekly reporting forms easy to complete 136 98.6 Recv’d weekly forms on timely basis 13295.7

11. Evaluation of Participation # n=138 % Agree Faxing reports did not present any problems 13295.7 Amt of detail requested was acceptable 13698.6 Frequency of ILI (weekly) was acceptable 13295.7 Interested in participating for other conditions on an ad hoc 10072.5

12. Received FluWatch reports each week frequencypercent Yes 8058.0 No No answer 57 1 41.3 0.7 Total 138100.0

13. Case definition of Influenza appropriate#% Yes 13799.3 No 1.7 Total 138100.0 Comments: o In a walk-in setting, I had lots of ILI by definition, which I knew to be other dx- pneumonia, strep, which I would label as such. o Difficulty with concurrent illness or unusual strains. o The definition was appropriate. However, for clarification purposes I would like to see the work “with” underlined or bolded. We had some discussion over this.

14. Did you take any clinical samples for influenza culture testing of ILI patients#% Yes 5036.2 No 8863.8 Total 138100.0 Taking clinical samples #

15. # Type of Clinical Samples Taken (n=50 sentinels with more than one choice in some cases)

16. Has participated year round (self-report)76/13855.1% Not willing to participate year-round but during regular FluWatch season only 50/13836.2% Not returning 3/1382.2% Unsure about returning 3/1382.2% Did not answer 6/1384.3% Total 138100/0% Applied for CME MainPro 2 credits for FW#% Yes 4331.2 No 9568.8 Total 138100.0

17. Practice Profile of Sentinels Does your practice focus on any particular group?#% Yes* 75.1 No 13094.2 No answer 1.7 Total 138100.0 *N.B. 4 mainly female patients, 1 in emergency, 1 focused on seniors

18. Geographic location of practice #% Urban/surburban 39 28.3 Inner City 5 3.6 Small Town 4230.4 Rural 44 31.9 Geographic isolated 8 5.8 Total 138100.0 Practice Profile of Sentinels

19. Overall age of your practice population #% no age predominates 44 31.9 40-64 51 36.9 >65 31 22.5 <40 12 8.7 Total 138100.0

20. Main Practice Setting #% Private Practice 9871.0 Community Clinic / CHC 2115.2 Academic FM teaching unit 118.1 Emergency Department 42.9 Free standing walk-in clinic, nursing home or remote nursing station 3,2.1 Did not answer 1.7 Total 138100

21. Patient Visits among sentinels (n=138) # 81/138 (58.7%) report up to 20% Of their patient visits are walk-ins

22. Conclusions / Recommendations spring of 2004 Health Canada decided to continue faxing reporting forms weekly for summer months large drop in sentinels agreeing to participate over the summer months was expected & did occur but not to the level of previous summers done on assumption that asking would underscore need for regularization of year-round surveillance year-round surveillance among NaRes Sentinels continues to rise to a limited extent (55%) in 2004 36.2% of 2003-04 surveyed sentinels still prefer to report ONLY during the regular season SARS and Avian virus threats may have heightened sentinel commitment necessary for year round reporting but additional CME promotion and effort is still required

23. Toronto 2004 FMF Influenza Workshop Attendees committed but concerned re: – Need for expansion – Lack of time – Compensation for surveillance work in primary care – Need for combining clinical & research updates in 1 CME session Researchers would like _ to find an RFP to support the testing/analysis of networked surveillance data from GP/FP practices _ Link surveillance to E-data capture methods to provide more timely feedback to sentinel physicians re: their own collective lab reports etc.

24. Attendees surveyed at the FMF workshop in Toronto confirmed that being a FluWatch sentinel kept them in the influenza information loop. They are concerned about new and emerging diseases as demonstrated by a comment from Dr. Peter McKean (PEI sentinel) “ I feel that it (sentinel surveillance) is of essential importance to public health. ” This concern was underscored by the fact that greater than half of the participants at the workshop do surveillance year round.