High acceptability of a national platform for public health genomic data sharing and surveillance in Australia: a mixed methods evaluation study

Background Pathogen genomics has increasingly been integrated into infectious disease surveillance, outbreak detection, and response globally. However, formal evaluation of pathogen genomic surveillance systems has been a major gap. Where evaluation has been undertaken, this has largely focused on economics, rather than assessing system attributes that contribute to the usefulness and acceptability of pathogen genomic surveillance systems. In Australia, the AusTrakka platform was established and deployed nationally to address barriers to genomic data sharing across jurisdictions, enhance interoperability and usability, and improve governance of public health genomic data. Here we present our evaluation of AusTrakka and examine how its utilisation and impact shifted throughout the COVID-19 pandemic. Methods We utilised the United States’ Centers for Disease Control (CDC) Updated Guidelines for Evaluating Public Health Surveillance Systems to guide assessment of the AusTrakka platform. The evaluation used a mixed-methods approach consisting of a quantitative analysis of AusTrakka utilisation data throughout the COVID-19 pandemic and a qualitative component comprised of key informant interviews and analysis of investigation reports produced by the AusTrakka National Analysis Team. Semi-structured individual and group interviews were held with key informants (n=63) representing all jurisdictions across Australia and New Zealand. These included individuals representing public health laboratories and health departments, infectious disease physicians, genomic epidemiologists and bioinformaticians. Results End users reported that AusTrakka had a very high degree of usefulness as a centralised platform to enable sharing sequence data across jurisdictions, facilitate multijurisdictional outbreak investigations and clarifying transmission chains. Acceptability was a key system that contributed to the usefulness of the platform, enhanced through collective design of data governance frameworks. Integration of epidemiological data with the pathogen genomic data was an ongoing challenge in data completeness. Conclusions Robust evaluation of pathogen genomics surveillance systems is critical to identify contextual and system elements that impact the capacity of these systems to accomplish their objectives. Our findings demonstrate the importance of strong stakeholder engagement in developing data governance mechanisms for pathogen genomics in ultimately ensuring the capacity of surveillance systems to detect outbreaks and support public health utility, and reinforce the value of a nationally developed, purpose-built approach in Australia.