Benefits of Program Collaboration, Service Integration and Data Sharing

1
Benefits of Program Collaboration, Service
Integration and Data Sharing
2
STD/HIV Collaboration Milestones

• 1987 - STD and HIV Programs adopt unified effort
  to maximize PS capacity.
• 1987 PS offered to CHD HIV clients by STD
  Program DIS.
• 1997 HIV Reporting (July 1997)
• 1998 - PS for HIV clients increased 46.
• 2002 Policy Change- PS Offered to all HIV
  Persons Tested Through C/T Sites.
• 2008 Automated HIV/STD record search
  capability via PRISM and HARS.

3

Fl
oridas confidentiality and security exists to
protect the individual and their medical
information, regardless of the disease, as part
of common practice in modern public health
programs.
4
Physical Security

• Hardware (server) locked within Data Center
  Building.
• Limited Access to building with monitored
  entrance 24/7.
• Background checks and security clearance policy.
• Agency/Program confidentiality and information
  security policies

Virtual Security

• Firewalls
• Active Antivirus,
• Security web scanning
• Behavior level monitoring
• Software to ensure latest security updates
• Network security that includes
• User accounts with applied security access
• Software level user identification and security
  controls

5
Modern Web Applications/BSTD and Area STD
Programs share security levels with internal
network devices, in addition to encrypted VPN
tunnels and no data stored on the device (simply
a view into software and data on the server).
Device registered on Network
VPN Encrypted Connection
Device registered on Network

• Mobile Connection
• Device registration
• User Authentication
• Software Authentication
• Window to Data Nothing resident on Device
  Memory

6
Future Health Information and Electronic Health
Records
Past Silo systems and databases divided by
disease
Healthy Evolution long term sustainability
7
Rationale for Integration in the Delivery and
Management of STD/HIV Partner Services

• 10 Years of steady decline in federal, state and
  local resources
• Combined resources to maximize prevention impact
• Significant overlap in populations served
• Significant and increasing STD/HIV co-infection
• Standardization of information security policies
  and procedures across disease control programs
• Vastly Improved performance outcomes through
  information exchange between STD and HIV Programs

8
Reported STD Cases by sex, among clients who had
a HIV test on, or prior to the date of their
STD diagnosis. Florida, 2005-2011
9
41.8
35
32.4
34.2
26.3
26.9
29
29.2
25
18.9
12.9
9.8
Syphilis Alone
Syphilis/HIV Co-infection
10
Inter-program and Technology Advances to Improve
Service Delivery and Performance Outcomes

• Standardization of Information Security Policies
  to allow for automated information exchange
  across Disease Control Programs. (All DOH staff
  accountable!!)
• Reciprocal data exchange between STD/AIDS
  Surveillance Reduction in NIRs and improved
  intelligence for HIV Partner Services
• Electronic lab reporting to reduce STD Prevention
  and PS timeframes
• Ability to conduct virtual QA/QI via PRISM

11
Inter-program and Technology Advances to Improve
Service Delivery and Performance Outcomes

• AIDS Surveillance monitors clients with
  subsequent STD infections via PRISM
• Included in Annual Epi-profiles
• Used as key variable to evaluate Prevention for
  Positives initiatives and to guide resource
  allocation
• Testing and Treatment History for Incidence
  Surveillance
• DIS collect previous testing and antiretroviral
  use during PS sessions. Information used by AIDS
  Surveillance when calculating incidence estimates
  

12
ELR and Data Sharing Reduced Timeframes for HIV
Partner Services
47
17
13
2010 HIV Partner Services - Florida
14
Reported Adult HIV (not AIDS) Cases, Florida
Through 2010 N44,957
Through 2005 N35,584
Data as of 06/30/2011
Data as of 12/31/2005
Note NIRs NOT redistributed.
15
PCSI is absolutely essential for disease control
programs to

• Maximize resources/increase efficiency
• Standardize and improve on information security
• policy and procedures (Fosters mutual
  confidence across programs that information will
  remain secure.
• Reach the greatest proportion of infected and
  exposed persons through PS, referral, link to
  services
• Provide holistic prevention services to clients