Towards Sustainable Public Health Surveillance in India: Using Routinely Collected Electronic Emergency Medical Service Data for Early Warning of Infectious Diseases

Infectious disease surveillance, timely detection and early warning of outbreaks present a complex challenge to health authorities in India. Approaches based on the use of unexplored data sources, like emergency medical services (EMS) data, can contribute to the further advancement of public health surveillance capacities in India and support and strengthen the Integrated Disease Surveillance Programme (IDSP) strategy. This research followed a mixed method approach including a series of semi-structured interviews and fever data analysis of the EMS operating dispatch system in Andra Pradesh, India. In this paper, we explore whether routinely collected EMS health data can improve sustainable infectious disease surveillance and early warning capacity. The result highlights the need for improved surveillance systems for early warning of infectious diseases in India. The data availability at the EMS dispatch centre includes patient data and spatial information and can be used for near real-time analysis. Routine data relevant for health surveillance can be extracted to provide timely health information that supplements and enhances more traditional surveillance mechanisms and thus provides a cost-efficient, near real-time early warning system for the operating states. The designed intervention is sustainable and can improve infectious disease surveillance to potentially help the government officials to appropriately prioritize timely interventions to prevent infectious disease spread.