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Surveillance

EpiNATO-2

EpiNATO-2 is the current and only operational health surveillance tool available to the Alliance. It was launched in 2013 and updated in January 2017 and is currently under investigation again. EpiNATO-2 starts with the completion of a weekly reporting format by all MTFs in a given theatre of operations. The intent is to classify every first attendance into one of 20 health event categories. It monitors a list of selected relevant diseases or injuries. They are selected on the basis of their importance as public health issues and potential impact on operational effectiveness. The less specific categories fill in the gaps to provide a full picture of the demand for healthcare to assist planning. EpiNATO-2 is implemented in all NATO Operations and is gradually being adopted in more non-NATO ones too. FHPB is authorised through its programme of work to support EU missions and requests from steering nations of the MILMED COE.

For EpiNATO-2 and NATO Health Surveillance overall, the continuous collecting of the data for the reporting is essential. MTFs transmit their data on a weekly basis via the Medical Advisor (MEDAD) to the FHP Branch in Munich. The FHP Branch analyses and prepares the feedback report and returns it to the MEDAD/CJMED for onward dissemination to higher command and back to MTFs. The EpiNATO-2 feedback report is intended to provide information about the health of the deployed force and early warning of emerging threats to their health. It is like a smoke detector in this respect by being sensitive to changes in the occurrence of illness. Unfortunately, it cannot explain why there has been a change and so further assessment and confirmation of the facts is necessary. This includes making use of local knowledge of the PAR, the operating environment, and anything else that could explain the real cause of the change.

Please find our e-learning course ADL 366 Surveillance Reporting on the JADL platform as well as all information about the Deployment Health Surveillance Courses on the FHP learning opportunities page.

Near-Real-Time-Surveillance (NRTS) tool

The NRTS tool “aims to identify incidents and outbreaks of infectious diseases or deliberate release at the earliest opportunity to facilitate prompt action”. It is important to keep in mind that it will provide no diagnosis. It is aimed for rapid detection of outbreaks to trigger investigations at a very early point of an event. There have been three stages of development in Phase One of the project. This started with the Coalition Warrior Interoperability Exercise in 2021 where we established that the tool worked and were able to share data with both NATO and National systems. The tool was also tested on CWIX 2022 where data was shared with the NATO data lake and we demonstrated compatibility with the OpenAltha patient electronic record system. Additionally, we conducted a live test on the CLEAN CARE Exercise 22 where we tested data entry with clinical staff. This gave us confidence to move into a live pilot phase in KFOR. The pilot in KFOR started in Nov 2022 with seven MTFs and was extended to 10 MTFs in Feb 23 for a further three months with the full support of the JMED team and Com KFOR. We have conducted a mid-term evaluation which identified some valuable lessons. Phase two of the development begins to expand the tool outside of the MILMED COE. This together with the alert function as well as the possibility to feed the tool with information gained from national electronic patient records will be some of the elements we are looking forward to test during VW/CC 24.

NRTS video on YouTube

STANAG and Vaccination catalogue

We are custodian for the STANAG 2535 “Deployment Health Surveillance” (currently under revision) and responsible for revising the “NATO Unclassified Vaccination Catalogue within the NATO and PfP Forces” every two years. It is a Standards Related Document (SRD-7 to AJMedP-4).

Search related standards in the STANAG searching tool.

Dashboard Global Health Surveillance

We have implemented external Global Health Surveillance databases into our routine work. While our surveillance systems, EpiNATO-2 and the Near-Real-Time Surveillance Tool, focus strictly on the health of our deployed soldiers, the Global Health Surveillance databases will show us the bigger picture by focusing on health events occurring in the civilian community outside the camp or in any relevant Area of Interest.