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

City/County Health Department

State Health Department

TIMSSTD*MISHARS

HARS STD*MIS TIMS NETSS EIP Systems

NETSS

STD*MIS (Optional at the Clinic)

TIMS (Optional

at the Clinic)

PHLISEIP Systems*

PHLIS

HARS STD*MIS TIMS NNDSS EIP Systems PHLIS

*EIP Systems (ABC, UD, Foodnet)

CDC

Data Sources

Physicians

Varied communications methods and security - specific to each system- including paper forms, diskettes, e-mail, direct modem lines, etc.

Varied communications methods and security - specific to each system - including diskettes, e-mail, direct modem lines, etc.

Chart Review

MMWR Weekly Tables MMWR Annual SummariesProgram Specific Reports and Summaries

Lab Reports

Reporting by Paper Form, Telephone

and Fax

Current Situation

Statistical Surveys for Chronic Diseases,

Injuries and Other Public Health Problems

Need for more information

• Bioterrorism, emerging infections

• Health reform

• Increased accountability

• Changing health care environment

• Consumer demand for data

• Data sources outside health arena

Motivators of Change

• Changing policy

• Increasing efficiency

• Evolving technology

• Increasing use of electronic information systems

• Enhancing security/confidentiality

The Vision

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.

Long-term ^

City/County Health Department

State Health Department

HIV/AIDS

HIV/AIDS

STD Clinics TB Clinics

HIV/AIDS

STDs

TB Notifiable Disease Reports

EIP Systems

Lab SurveillanceCDC

Data Sources

Physicians

Electronic data interchange (EDI) using HL7 or other standardized format

Chart Review

Lab Reports

Secure Internet

Secure InternetElectronic data interchange (EDI) using HL7 or other standardized

format

Shared Facilities and Services, e.g. common

interface, software components,

terminologies and data files

Shared Facilities and Services, e.g. common

interface, software components,

terminologies, and data files

Secure Server

Vital Statistics

Emergency Departments

Medicaid, Medicare Encounter

s

Hospital Discharge

Data

Secure electronic reporting

Paper Forms, Telephone and FAX

Proposed Integrated Surveillance Systems Solution

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

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

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

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