Cloud-based Electronic Health Records for Real-time, Region-specific Influenza Surveillance

Introduction Influenza is a leading cause of death in the United States (US), where up to 50,000 are killed each year by influenza- ‐like illnesses (ILI) [1]. Therefore, monitoring, early detection, and prediction of influenza outbreaks are crucial to public health. Disease detection and surveillance systems provide epidemiologic intelligence that allows health officials to deploy preventive measures and help clinic and hospital administrators make optimal staffing and stocking decisions [2]. The US Centers for Disease Control and Prevention (CDC) monitors ILI in the US by gathering information from physicians' reports about patients with ILI seeking medical attention [3]. CDC's ILI data provides useful estimates of influenza activity; however, its availability has a known time lag of one to two weeks. This time lag is far from optimal since public health decisions need to be made based on information that is two weeks old. Systems capable of providing real- ‐time estimates of influenza activity are, thus, critical. Many attempts have been made to design methods capable of providing real- ‐time estimates of ILI activity in the US by leveraging Internet- ‐based data sources that could potentially measure ILI in an indirect manner [4, 5, 6, 7, 8, 9, 10, 11].