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. Program Specific Reports and Summaries MMWR Weekly Tables MMWR Annual Summaries Current Situation Statistical Surveys for Chronic Diseases, Injuries and Other Public Health Problems STD*MIS 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 STD*MIS 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 HARS STD*MIS TIMS NETSS EIP Systems* PHLIS City/County Health Department *EIP Systems (ABC, UD, Foodnet) STD*MIS (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. Long-term ^ 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.

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