CASE NOTES
Intervention project to enhance disease surveillance in the Northern Tablelands of New South Wales
Kate Burren, District Veterinarian, Northern Tablelands Local Land Services, Glen Innes
Posted Flock and Herd August 2025
Prepared as part of the author's participation in the 2024 NSW Animal Health Frontline Field Epidemiology Training Program
Introduction
In August 2024 in the Northern Tablelands, there appeared to be an increase in the number of abortions and stillbirths in cattle, particularly in the southern part of the region. On further investigation, it appeared that the problem was at least in part due to arboviruses. Unfortunately, lack of data prevented an in-depth assessment of the situation. The only available data were Local Land Services (LLS) investigations recorded in LHMS. Many possible cases of abortions and stillbirths or calves with arthrogryposis that may have been seen by either the producer or private veterinarians were not reported to LLS veterinarians. Some producers may also communicate more with their private veterinarians than LSS veterinarians. These cases were never reported to an LLS veterinarian and made available in LHMS for data analysis.
There is a significant amount of surveillance being performed by the private veterinarians in the Northern Tablelands region and access to this data would be invaluable. Additional reporting from private veterinarians would be valuable not only for this investigation, but also for monitoring for other possible disease outbreaks. Further evaluation was required to increase data from private veterinarians in LHMS (and Power BI), to enhance disease surveillance and allow for more meaningful conclusions within the region.
Critical Causes
Using a fishbone diagram to analyse the problem (figure 1), it was decided to initially focus on all private veterinarian reports being entered into LHMS and increasing communication with private veterinarians.
Figure 1. Fishbone diagram exploring possible critical causes for lack of private veterinarian data
Design an intervention
The objective of the interventions was to increase the number of private veterinarian entries on LHMS each month, as well as to increase the amount of communication or interaction with private veterinarians.
Entering lab reports into LHMS is a very straightforward solution to increase data, however would only capture cases where laboratory testing is performed.
Communication between LLS and private veterinarians is a more difficult and broad area with many possibilities. There are also more barriers, including time available (especially with the private veterinarians) and how different individuals best communicate. Activities to be undertaken included: Microsoft Forms surveys for increased data collection (initially specific, eventually becoming more broader); more regular email bulletins (with quick, topical information); quarterly newsletters; discussions with private veterinary practices on their thoughts of how to increase the communications; drop-in to veterinarians to discuss current matters; information nights on bigger topics; possible financial help for testing of herds with specific syndromes; and other possible incentives to increase private veterinarian reporting.
Indicators for the interventions included how many entries on LHMS before and after the interventions (i.e. how much more data is available) and the amount of communication and interactions between LLS and private veterinarians per month.
Implementation and monitoring of the interventions
As of July 2024 in the Northern Tablelands, all private veterinarian laboratory results with an identifiable PIC were added to LHMS once results were finalised. As much information as possible was recorded from both the results and laboratory submission forms.
In August 2024, all private veterinarians in the Northern Tablelands were sent a simple Microsoft Forms survey 'Akabane Survey 2024'. This survey contained only five questions to be answered relating to possible Akabane cases either reported to them or through property visits. This information was then recorded in LHMS under a phantom district PIC to allow for retrieval of the data in Power BI. This survey was followed up by a bulletin a couple of weeks later, reminding veterinarians of the survey and advising of the increase in case numbers and best testing protocols.
The number of private veterinarian entries in LHMS through both interventions was and will continue to be monitored over time to see if additional data was available and, therefore, whether the interventions appeared to be working.
Private veterinarian engagement with LLS through conversations, reports, enquiries, etc. was considered too complex to be evaluated at this stage, as most of these interactions are not currently recorded unless via LHMS entries.
Evaluation of the interventions
As of the end of October 2024, there had been a large increase in the amount of data available in LHMS. The number of entries in LHMS by private veterinarians in the Northern Tablelands was compared over the last five years (figure 2). It was found that between 2020 and 2023, the number of entries ranged from thirteen to twenty. In 2024, there had been a significant increase, with 119 entries by the end of October. This number of entries included 110 from the entry of private veterinarian laboratory results and nine reports from the survey.
Figure 2. Private veterinarian cases in LHMS in the Northern Tablelands over the last five years
The private veterinarian cases from 2024 were further analysed (figure 3). It was found that there were zero entries in January and February, and between one to nine in March to June. In July when the intervention to enter laboratory results began, the number of records increased to 30. In August, after the survey started, the number increased slightly to 34 records. In September, there were 28 reports and in October only seven so far. However, this number for October is likely to increase, due to the time taken between when samples are submitted for testing (the event date) and when testing is completed, which is the point at which results are entered into LHMS.
Figure 3. Private veterinarian cases in LHMS in the Northern Tablelands in 2024.
The number of private veterinarian entries were compared to LLS entries for 2024 (figure 4). Between July and September, once the intervention was implemented, the number of private veterinarian entries surpassed the LLS entries and therefore more than double the amount of data was available for disease surveillance and monitoring.
Figure 4. LLS versus private veterinarian entries in LHMS in the Northern Tablelands in 2024
In 2024, there were a total of 44 cases of abortions or stillbirths in cattle reported in LHMS in the Northern Tablelands (figure 5). The number of cases consisted of 31 private veterinarian cases and 13 LLS cases. This almost-three-fold increase in available data gives a much larger insight into the abortions occurring throughout the region.
Figure 5. LLS versus private veterinarian entries in LHMS for cattle abortions and stillbirths in the Northern Tablelands in 2024
Further Exploration
Further interventions will be explored in the future. These interventions will aim to increase data available for additional surveillance, for example for diseases that may be treated by private veterinarians but for which there are no samples submitted to the state laboratory for testing. Discussions with local private veterinarians will continue to explore how best to increase their engagement with the LLS (through the survey format via Microsoft Forms, email chains, drop-in sessions, information evenings, etc.).
Email bulletins with quick, topical information and quarterly newsletters will continue. Further exploration on how to reach all veterinarians within a practice is required as during this project it became evident that not all veterinarians in a practice were seeing the information through the practice email.
Incentives for private veterinarians to contribute to data collection is another possible area for evaluation. These incentives may include financial help with labortory testing of syndromes of interest. This incentive was trialled with one local veterinary clinic that was particularly interested in recent abortion cases via the subsidising of some laboratory testing through local district surveillance. It not only increased the volume of testing performed, but helped to strengthen the relationship between this veterinary clinic and the LLS.
Further data collection may also be possible by obtaining district-level abattoir surveillance data from MLA. This data could then be recorded on LHMS under a phantom district PIC to allow for data to be retrieved using Power BI.
Conclusions
The collection of private veterinarian data will be a priority, to enhance disease surveillance in the Northern Tablelands region. The Northern Tablelands has eight local private veterinary clinics that undertake a significant amount of animal production work and surveillance, three of which are in regions without an LLS office. Tapping into this resource will significantly increase the amount of available data. More data could highlight possible disease situations or outbreaks and improve understanding of disease burdens in the region. Results from analyses could be reported back to private veterinarians, producers, the board and potentially industry and allow better informed decision making and extension.
Acknowledgements
The data for this analysis was sourced from local private veterinarians including laboratory submissions, uploaded to LHMS and then extracted from Power BI.
This project was completed as part of the NSW Animal Health Frontline Field Epidemiology Program and I would like to thank all those involved in the program. I would also like to thank Kate de Jong for her assistance with reaching out to private veterinarians as part of this project. I would particularly like to thank Andrew Biddle for his support, enthusiasm and mentorship of this project to allow it to get off the ground.