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NNDSS Modernization Initiative (NMI): NNDSS-Related Highlights from 2019 CSTE Annual Conference

NNDSS Modernization Initiative (NMI): NNDSS-Related Highlights from 2019 CSTE Annual Conference. Division of Health Informatics and Surveillance. July 16, 2019. Agenda. Welcome and Announcements 2019 CSTE Annual Conference and NNDSS-Related Sessions Questions and Answers .

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NNDSS Modernization Initiative (NMI): NNDSS-Related Highlights from 2019 CSTE Annual Conference

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  1. NNDSS Modernization Initiative (NMI): NNDSS-Related Highlights from 2019 CSTE Annual Conference Division of Health Informatics and Surveillance July 16, 2019

  2. Agenda • Welcome and Announcements • 2019 CSTE Annual Conference and NNDSS-Related Sessions • Questions and Answers 

  3. NMI Announcements Lesliann Helmus, MSPH, CHTS-CP Associate Director for Surveillance Michele Hoover, MS Lead, State Implementation and Technical Assistance

  4. NMI eSHARE Webinar Highlights from the 2019 CSTE Annual Conference Kate Goodin, MPH, MS Meredith Lichtenstein Cone, MPH Shaily Krishan, MPH Barbara Gabella, MSPH Richard Danila, Ph.D., MPH Molly Crockett, MPH Sherri Davidson, Ph.D., MPH Tuesday, July 16, 2019 3:00-4:00 pm ET

  5. Agenda • Overview of 2019 CSTE Annual Conference & Overview of NNDSS-related sessions- Shaily Krishan (CSTE) • Review of approved 2019 CSTE Position Statements • Infectious Disease Position Statements- Richard Danila (MN) • Non-infectious Disease Position Statements- Barbara Gabella (CO) • Recap of S/I conference workshop- Kate Goodin (AZ) • CSTE Workgroups and projects- Molly Crockett (MA), Sherri Davidson (AL) • Surveillance/ Informatics Steering Committee Roundtable summary- Kate Goodin • 2019-2020 Surveillance/ Informatics priorities- Kate Goodin • Q & A

  6. Overview of 2019 CSTE Annual ConferenceShaily Krishan

  7. Attendance • 1,607 registered attendees • State Health Agency: 48% • Local Health Agency: 16% • Federal Agency: 15% • Student: 2% Conference Workshops • Sunday, June 2 • 14 workshops • Beginning in 2019, the State Epi Forum will be recurring every year • 1,083 attendees Conference Sessions • Mon-Wed, June 3-5 • 8 tracks • 712 total presentations • 225 Breakout • 228 Quick • 59 Lightning • 132 Posters • 68 Roundtables • 3 Sponsor Roundtables t

  8. CSTE Annual Business Meeting • Thursday, June 6 • Review of Voting Rights and Council Audit • State of CSTE Address – Sarah Park • Presentation of 2019 Position Statements • New Business and Installation of New President, Sharon Watkins

  9. CSTE Executive Board 2019-2020 Officers • President: Sharon Watkins, PA • Vice President: Sarah Park, HI President-Elect: Sherri L. Davidson, AL Secretary-Treasurer: Marcelle Layton, NYC Steering Committee Chairs Infectious Disease: Richard Danila, MN Chronic Disease/MCH/Oral Health: Angela Dunn, UT Environmental/Occupational/Injury: Melissa Jordan, FL Surveillance/Informatics: Kate Goodin, AZ (Maricopa County) Cross Cutting I: Barbara Gabella, CO Cross Cutting II: Kenneth Komatsu, AZ

  10. NNDSS Related Roundtable Sessions • Defining the Future for NNDSS (June 3) • Leveraging the NNDSS infrastructure for exchange of other types of case-based surveillance data • New strategies for data presentation and access • Methods to make the data more timely and relevant, providing feedback on data quality, maintaining the integrity of the initial data transmitted • Increasing CDC’s capacity to onboard states to send HL7-based messages • Implementation of ‘Country of Usual Residence’ in the 2019 Tables of National Notifiable Infectious Diseases and Conditions (June 3) • Provided background for why 2019 NNDSS tables of infectious diseases and conditions are stratified by “Country of Usual Residence” (COUR) • Suggestion to identify a state author to update position statement 11-SI-04 to include updated guidance about the Country of Usual Residence data element (which replaced the foreign resident data element)

  11. NNDSS Related Roundtable Sessions (continued) • NNDSS Low Incidence and International Quarantinable Disease Verification Protocol: Suggestions for Changes and Enhancements (June 4) • Describe the process for CDC to verify low incidence conditions based on the 03-ID-11 PS; proposed enhancement to the CDC MVPS to make the verification process more transparent or update 03-ID-11 PS about low incidence verification • Recommendation to discuss low incidence verification processes within NNC Criteria Workgroup (Surveillance Policy Subcommittee) • Informatics and CDC Emergency Response: Options for Standardizing Emergency Case Notification Messaging to CDC (June 5) • Presented strategies to utilize current NNDSS infrastructure for jurisdictions to submit standardized emergency case data for domestic events, special studies or evolving diseases • Presented options to use Generic v2 as a base for emergency response variables, or a stand-alone MMG containing data elements for emergency response

  12. For more information.. 2019 Annual Conference Presentation Recordings: • CSTE Confex Website: https://cste.confex.com/cste/2019/meetingapp.cgi 2019 Position Statements – Coming Soon! • Position Statement Archive: https://www.cste.org/page/PositionStatements?

  13. Review of approved 2019 CSTE Position Statements: Richard Danila, Barbara Gabella

  14. Approved 2019 CSTE Position Statements: Infectious Disease • 19-ID-01: Public Health Reporting and National Notification of Plague • 19-ID-02: Standardized Surveillance Case Definition for Blastomycosis • 19-ID-03: Case Definition for Non-pestis Yersiniosis • 19-ID-04: Revision to the Case Definition for National Legionellosis Surveillance

  15. Approved 2019 CSTE Position Statements: Infectious Disease (continued) • 19-ID-05: Revision to the Standardized Case Definition, Case Classification, and Public Health Reporting for Acute Flaccid Myelitis • 19-ID-06: Revision of the Case Definition for Hepatitis C • 19-ID-07: Changes to Public Health Reporting and National Notification for Spotted Fever Rickettsiosis (including Rocky Mountain Spotted Fever) • 19-ID-08: Revision to the Case Definition for National Pertussis Surveillance

  16. Approved 2019 CSTE Position Statements: Non-infectious Disease 19-MCH-01 – “Neonatal Abstinence Syndrome Standardized Case Definition” • Creates two tiers: (1) Providers and laboratories report to public health legal authorities, and (2) Public health staff analyze ICD-10-CM coded data from providers and facilities. • Does NOT recommend adding to Nationally Notifiable Conditions List. 19-CC-01 – “Nonfatal Opioid Overdose Standardized Surveillance Case Definition” • Creates standardized definition, which will encourage comparable estimates across jurisdictions, building upon CDC work. • Does NOT recommend adding to Nationally Notifiable Conditions List.

  17. Recap of S/I Conference Workshop:“Surveillance: Getting from Data to Action”Kate Goodin

  18. Workshop Themes Data Acquisition Data Marketing Data Sharing and Release Workforce

  19. CSTE Workgroups and ProjectsMolly Crockett, Sherri Davidson

  20. Data Standardization Workgroup • Co-chairs: Molly Crockett (MA): Molly.Crockett@state.ma.us,  Laura Erhart (AZ): laura.erhart@azdhs.gov • Workgroup charge: To convene epidemiologists and informaticians to develop consensus on common definitions for core surveillance data elements to address jurisdictional variation • Workgroup mission: Improve data quality through the development and application of consensus definitions for the core data elements for general communicable disease surveillance

  21. Data Standardization Workgroup • Outputs: • Consensus reports pertaining to surveillance processes, definitions of data elements or other practices under consideration • Developed CSTE Issue Brief titled “Data Standardization: Dates of Importance to Public Health Surveillance” • Data elements in Generic v2.0 and Generic v2.0-based message mapping guides (MMGs) included in brief: Illness (Symptom) Onset Date, Report Dates, Laboratory-Related Dates, (Clinical) Diagnosis Date • Where applicable, recommend integration into future updates to GenV2 or as part of GenV3 • Aimed at standardizing data elements sent to CDC or used nationally • Develop a standardized, repeatable process for reaching a consensus definition • Meeting schedule: Monthly, fourth Friday 1-2 ET, next meeting is July 26 • CSTE staff contact: Shaily Krishan (skrishan@cste.org)

  22. NMI Evaluation Workgroup • Workgroup charge: To convene epidemiologists, informaticians, and surveillance experts from state, local and territorial jurisdictions participating in NMI Message Mapping Guide (MMG) implementation activities, and other key stakeholders to evaluate and identify improvements in processes related to MMG implementation, MMG onboarding, MMG maintenance, and Technical Assistance (TA) • Convened in April 2019, meets monthly • Next call: July 23, 3-4 ET • CSTE staff contact: Shaily Krishan (skrishan@cste.org)

  23. NMI Evaluation Workgroup Activities • Conduct structured workgroup discussions to develop the NMI Evaluation Assessment to address: • Barriers encountered by jurisdictions in the MMG implementation and/ or onboarding process • Usefulness of NMI technical assistance (TA) • Sustainability of jurisdiction's investments in overall MMG implementation, onboarding and maintenance activities • Satisfaction of jurisdictions with the overall experience of MMG implementation, onboarding, and technical assistance • Satisfaction of jurisdictions with CDC's efforts to standardize and harmonize MMGs, and to involve jurisdictions in the development and piloting of MMGs • Conducted MMG Implementation Listening Session with CSELS, CDC programs and states to discuss challenges that jurisdictions encounter during MMG implementation, and identify methods for CDC to make process improvements

  24. NNC Criteria Workgroup • First meeting was held on July 16, future meeting schedule coming soon! • Contact Alexis Darden to join workgroup (adarden@cste.org) • Consider why conditions are nationally notifiable • Document criteria for adding/retaining • Produce a Policy Brief • Once we establish NNC criteria, review all current NNCs through that lens • Draft PS to remove all NNCs not meeting retention criteria • Consider recommending sections to PS template that authors will complete in the NNC section that explicitly lists how/why it meets the criteria, and perhaps adding a term limit for NNCs to expire, or be renewed

  25. Summary of Syndromic Surveillance Roundtable • Community requests clarification on how SyS data submitted to CDC is being used • Findings released at regional or national level? • Future plans for data use? • What level of re-release is part of the base cooperative (funding) agreement? • Potential action items: • Increased collaboration between states and CDC • Determine a way for communication between affected states and CDC prior to publication of data • Position statement on data release policies for SyS • SyS POC list  

  26. Surveillance/Informatics Steering Committee Roundtable SummaryKate Goodin

  27. Feedback • Are there critical surveillance and informatics areas not represented by the current committee structure? • Non-infectious diseases • Legal, governance, privacy • Workforce • Cross-program solutions • What do you see as the most critical issue facing you in the next year? • Staffing • MMG timelines • How could CSTE and this committee support you? • “Advocacy” with CDC • Public health lab communication and connection • Core functions: • Defining informatics • Standardization • Visioning • Cross sector collaboration • Training • How do you prefer to be engaged? • Emails (9) • Conference calls (10) • Peer-to-peer mentorship (8) • Polls/surveys (1)

  28. 2019-2020 S/I PrioritiesKate Goodin

  29. Planning for the future • Strategic planning • Internal forces: • Funded projects • Organizational capacity • External forces: • Funding • Other organizations • Needs of STLT HD informatics staff

  30. Questions? Questions on Position Statements? • Email Meredith Lichtenstein Cone (mlichtenstein@cste.org) Questions on the Data Standardization Workgroup or NMI Evaluation Workgroup? • Email Shaily Krishan (skrishan@cste.org) Questions on the NNC Criteria Workgroup? • Email Alexis Darden (adarden@cste.org)

  31. Subscribe to monthly NMI Notes news updates athttps://www.cdc.gov/nmi/news.html Access the NMI Technical Assistance and Training Resource Center at https://www.cdc.gov/nmi/ta-trc/index.html Request NMI technical assistance or onboarding at edx@cdc.gov Next NMI eSHARE is August 20, 2019 – details at https://www.cdc.gov/nmi/eshare.html

  32. CSTE National Office Contact Information CSTE National Office 2635Century Parkway NE, Suite 700 Atlanta, Georgia 30345 770.458.3811 770.458.8516 skrishan@cste.org

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