Public health gets new digital view of infectious disease outbreaks and vaccines

Nova Scotia has implemented a new public health information system that could help track vaccines and outbreaks of infectious diseases, including measles.

The province joins seven other jurisdictions that use Panorama: British Columbia, Yukon, Saskatchewan, Manitoba, Ontario, Quebec and New Brunswick.

Public health has implemented three Panorama modules over two phases, the last of which went live in December. The modules will help in investigating outbreaks, tracking people's vaccine records and keeping vaccine inventories in check.

Before implementing the electronic system, public health workers recorded cases of infectious diseases mostly on paper.

Lori McCracken, the province's health protection manager for Nova Scotia's northern zone, said the paper records were located in different public health offices across the province. With Panorama, records are kept in one place.

"One of the great things about Panorama in terms of helping in an outbreak is just having more timely access to information," said McCracken.

Panorama will help public health nurses all over the province collaborate to control the spread of an outbreak and find its causes.

Dr. Joannne Langley sees great potential in Panorama.

"If there's an outbreak, you can check your system to see who are the high priority people that haven't got vaccine yet," said Langley, the head of pediatric infectious diseases at the IWK Health Centre and a vaccine researcher at the Canadian Center for Vaccinology at Dalhousie University.

Tracking vaccines will be more efficient

The new electronic system will also work as a provincial immunization registry.

Before Panorama, the system for tracking vaccines depended on paper charts, an obsolete database and the famous yellow cards with columns of shots, check marks and dates.

Now, Nova Scotians who got vaccinated within the last five years by a public health worker in Nova Scotia have electronic records of the vaccines they received.

Also, everyone born in or after 1998 has their immunization records in Panorama, according to McCracken, so long as they have been administered by or shared with a public health worker.

Having a central vaccine registry will help public health workers identify communities with low vaccination rates and target services to these communities.

But the system needs more work before it can be used to assess vaccine coverage.

"What we need is for it to incorporate all vaccines that Nova Scotians get regardless of the provider," Langley said. "We have pharmacies, family doctors … we have vaccines that are given in hospitals. We need the whole story to be able to have it exist as a really functional vaccine registry."

Still, Panorama helped a doctor check her immunization records after being potentially exposed to measles recently at the Halifax Infirmary.

"They were able to look it up immediately on Panorama and find out that she had two doses of MMR," said McCracken.

School immunizations

Panorama is also used in school immunization clinics. Public health nurses take laptops to schools and record information directly into the system.

"If there's any alerts for any of the students, so such as they had a previous incident with one of their immunizations or maybe they even have a warning because, you know, maybe this child is prone to fainting … the nurse was actually able to see all of that," said McCracken.

McCracken said the complete records of those born in or after 1998 have been entered because this age group is most likely to request that information, and some offices couldn't transfer earlier records.

If Nova Scotians born before 1998 want to get their records into Panorama, it could be a lengthy process.

"We don't have a scanning system to enter that data," said McCracken. "It may have to be manually entered and then verified."

Accessing your immunization records

Public health workers are the only people with access to Panorama now.

People who wish to get their complete immunization records would have to contact their closest public health office. Vaccines received outside the province would not be recorded, unless people shared them with public health in Nova Scotia.

"If they requested it and they said, 'Oh, actually my yellow card said it's something else,' we would look into that for them and make sure that they have the most accurate information," said McCracken.

McCracken encourages people who moved to Nova Scotia from another province or country to bring their immunization records to a public health officer.

"That's the best way for us to have the information and to get it up to date," she said.

Vaccination is key to stop outbreaks

People can manually enter their vaccinations in the CANImmunize app for personal record-keeping. But the app is not connected to Panorama.

Restricted access to the system is not only challenging for citizens, but it's also a problem for physicians, especially when they get new patients.

"They would have to bring their own records with them, because I directly don't have access to a repository of what vaccines they've got," said Langley.

Although Panorama can help track the spread of infectious disease outbreaks, people should not rely on it in lieu of getting vaccinated.

"There is no question that vaccinating before exposure is the best way to prevent these diseases," said Langley.