National Notifiable Disease Surveillance

1
National Notifiable Disease Surveillance

• CSTE/CDC collaboration
• Reporting mandated at state level
• Reportable diseases vary by state
• Health care providers, labs report to local HD
  (county)
• Counties report to State
• Voluntary reporting by states to CDC

2
MMWR Weekly Tables
MMWR Annual Summaries
Program Specific Reports and Summaries
Current Situation
Statistical Surveys for Chronic Diseases,
Injuries and Other Public Health Problems
STDMIS
TIMS
NNDSS
EIP Systems
PHLIS
HARS
CDC
Varied communications methods and security -
specific to each system - including diskettes,
e-mail, direct modem lines, etc.
Data Sources
Reporting by Paper Form, Telephone and Fax
State Health Department
HARS
STDMIS
TIMS
NETSS
EIP Systems
PHLIS
Physicians
Varied communications methods and security -
specific to each system- including paper forms,
diskettes, e-mail, direct modem lines, etc.
Chart Review
Lab Reports
TIMS
STDMIS
HARS
NETSS
PHLIS
EIP Systems
City/County Health Department
EIP Systems (ABC, UD, Foodnet)
STDMIS (Optional at the Clinic)
TIMS (Optional at the Clinic)
3
Need for more information

• Bioterrorism, emerging infections
• Health reform
• Increased accountability
• Changing health care environment
• Consumer demand for data
• Data sources outside health arena

4
Motivators of Change

• Changing policy
• Increasing efficiency
• Evolving technology
• Increasing use of electronic information systems
• Enhancing security/confidentiality

5
The Vision
Long-term

• Complementary electronic information systems
  that
• - automatically gather health data from a variety
  of sources on a real-time basis,
• - monitor the health of communities,
• - assist in the ongoing analyses of trends and
  detection emerging public health problems, and
• -provide information for setting public health
  policy.

6
Proposed Integrated Surveillance Systems Solution
TB
Notifiable Disease Reports
Secure Server
STDs
EIP Systems
HIV/AIDS
Lab Surveillance
Data Sources
CDC
Electronic data interchange (EDI) using HL7 or
other standardized format
Secure Internet
Physicians
Paper Forms, Telephone and FAX
Shared Facilities and Services, e.g. common
interface, software components, terminologies and
data files
Chart Review
HIV/AIDS
State Health Department
Lab Reports
Electronic data interchange (EDI) using HL7 or
other standardized format
Secure Internet
Secure electronic reporting
Vital Statistics
Shared Facilities and Services, e.g. common
interface, software components, terminologies,
and data files
Emergency Departments
HIV/AIDS
City/County Health Department
Medicaid, Medicare Encounters
Hospital Discharge Data
STD Clinics
TB Clinics
7
A common framework for surveillance information
systems

• Common data architecture (model, definitions,
  coding)
• Automated electronic reporting of data, e.g. HL7
  messages for notifiable diseases
• Secure Internet pipeline for reporting to CDC
• Consistent user interface
• Reusable software components, e.g. outbreak
  detection algorithms
• Shared analysis and dissemination methods

8
Some Requirements for Integrated Systems

• Patient registry matching
• Rapid development and deployment of data entry
  screens
• Internet data entry
• Pyramid reporting and synchronization (clinic to
  local to state to CDC)
• HL7 import and export

9
Related Projects

• Electronic Laboratory Reporting pilots
• Negotiations for SNOMED license
• Data Elements for Emergency Departments pilot
  project
• Bioterrorism cooperative agreements
• Standards Development Organizations activities
• State integration activities

10
Next steps for Integration Project

• pilot test specifications and standards
• use specifications and standards in new system
  development--CDC and states
• funding proposed in FY2000 to support information
  system infrastructure
• engage public health community in ongoing
  standards development activities-- HIPAA, CDC