Practical Systems for Biosurveillance: The Military Perspective and Essence

The Department of Defense (DoD) developed the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) as an attempt to use already collected electronic outpatient data in a way that could detect abnormal patterns in acute infectious disease incidence. ESSENCE was created through partnerships with academia and other government organizations, and allowed near real-time tracking of disease trends both temporally and spatially. Since its inception, ESSENCE has been expanded to include local civilian health data, advanced detection algorithms, and patient identifiers for appropriate public health officials to assist with disease investigation. ESSENCE is now an essential component of military installation protection and a key part of the US national public health surveillance system. Keywords: syndromic surveillance; bioterrorism; military health system; outbreak detection