Department of Biostatistics
Public Health Surveillance Working Group

2008 - 2009

Organizer: Justin Manjourides

Schedule: Fridays, 12:30-1:30 p.m.
HSPH2, Room 426 (unless otherwise notified)

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Seminar Description
This working group will focus on statistical issues related to public health surveillance. There will be special emphasis placed on biosurveillance and monitoring for bioterrorist attacks. Talks will be accessible to students, as well as researchers and other officials outside of the biostatistics department.


October 17

Michael A. Stoto, Ph.D.
Professor of Health Services Administration and Population Health, Georgetown University School of Nursing & Health Studies
Adjunct Professor of Biostatistics, and Director of the Evaluation Core, Center for Public Health Preparedness, Harvard School of Public Health

"Privacy and Confidentiality, and Other Legal and Ethical Issues in Syndromic Surveillance: Report from an International Society for Disease Surveillance Consultation"
ABSTRACT: For syndromic and related public health surveillance systems to be effective, health departments need access to a variety of types of health data. Since the development and implementation of syndromic surveillance systems in recent years, health departments' experience in gaining access to personal health information for syndromic surveillance has been mixed. Although the HIPAA Privacy Rule permits healthcare providers to disclose protected health information without patients' consent to public health agencies for authorized purposes, some healthcare providers have cited HIPAA in refusing to provide data for syndromic surveillance. Beyond HIPAA, a variety of federal, state, and local public health laws enable, restrict, and otherwise influence the sharing of health information between healthcare providers and public health agencies for surveillance, as well as research, purposes. To address these issues, an expert meeting was convened to (a) share experiences regarding privacy, confidentiality, and other legal and ethical issues; (b) clarify how these legal and ethical issues enable or constrain data sharing; and (c) identify approaches to protect privacy and confidentiality.

Rooted in the principle that the state and local governments have inherent and broad powers to protect the health, safety and welfare of the people, public health agencies have the authority to collect personal health information, including the power to compel disclosure of such data under certain conditions. The precise limits of these public health powers have never been defined, however, and are limited by and must be balanced with the right of privacy. Although existing laws and regulations provide little clarity on how to balance disclosure risks and potential benefits of public health actions that reasonably follow from surveillance, guidance can be found in the principles known as the “Fair Information Practices.” Two specific fair information practices – specification of purpose and limitation on secondary use – are especially critical for syndromic surveillance.

Considering these principles should lead health officials to consider when and in what settings de-identified data are sufficient for the intended public health purpose, and whether surveillance will lead to effective public health action. The principles also suggest a number of strategies for dealing with concerns about sharing data with public health agencies: (a) improve communication with the public about how data are used to safeguard the population’s health and how confidentiality is protected; (b) further develop approaches to sharing data in aggregate or de-identified form that have capability to link back to identified data when necessary, (c) further develop statistical approaches to anonymization and aggregation, and (d) conduct evaluation research and case studies that demonstrate utility and clarify how privacy and confidentiality are protected.

November 21

Mikaela Keller, Ph.D.
Research Fellow, Children's Hospital Boston Informatics Program

"Natural Language Processing for Healthmap.org"
ABSTRACT: None Given
December 12 (joint with Environmental Statistics Seminar in FXB G11)

Janice Weinberg, Sc.D.
Associate Professor of Biostatistics, Department of Epidemiology & Biostatistics, Boston University School of Public Health

"Talk Title TBA"
ABSTRACT: None Given
February 13

Lynn A. Bethel, RDH., BSDH, MPH
Director, Office of Oral Health, Mass Department of Public Health

"The National Oral Health Surveillance System: Data for Directing Dental Public Health Policy and Programming"
ABSTRACT: None Given
March 6

Veronica Vieira, DSc.
Assistant Professor, Department of Environmental Health, Boston University School of Public Health

"Talk Title TBA"
ABSTRACT: None Given
April 3

Speaker TBA


"Talk Title TBA"
ABSTRACT: None Given
April 24

Theodore H. Cohen, M.D., D.PH
Assistant Professor of Medicine, Harvard Medical School / Brigham and Women's Hospital

"Tuberculosis Surveillance"
ABSTRACT: None Given


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Last Update: October 2, 2008