1. TM Transition to Interoperable Electronic Systems for TB Surveillance Presentation to the NEDSS Stakeholders Meeting Jose Becerra, MD, MPH and Sandy Price, PMP Division of TB Elimination July 27, 2010

2. TM Electronic TB Surveillance: 1998-2008 TB Information Management System (TIMS “silo” = “cylinder of excellence”) [S ave the silo!] Client-server technology Multiple databases to synchronize Modem transfers of RVCT data Import utility 2

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4. ----- Original Message ----- From: "Becerra, Jose" To: "Broome, Claire MD"; "Loonsk, John W., M.D." Cc: "Castro, Kenneth G"; "Navin, Thomas R." Sent: Tuesday, March 06, 2001 1:27 PM Subject: TIMS/NEDSS Claire/John: This is how and why disease-specific information systems get started (1). Any integration efforts must consider the history of these systems and provide consistent reassurance that data quality and integrity will be maintained. A recent paper published by our Division (2) provides a good baseline as we plan to fully integrate TIMS into NEDSS. I suggest that two primary objectives of the TIMS integration effort into NEDSS be: i) confirm completeness, and ii) improve the timeliness of TB case reporting in the United States. i) confirm completeness, and ii) improve the timeliness of TB case reporting in the United States. 4

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6. DTBE Baseline TB Information Management System (TIMS) >90% completeness of reporting Very high data quality (>250 checks at data entry) TIMS Import Utility Developed to import data into TIMS for states using other systems Validated quality on import

7. TM DTBE Main Objectives Maintain and improve completeness and quality baseline Improve timeliness of reporting (real time data) Decrease burden of collection for health care providers and local program staff by relying more on electronic messaging

8. TM DTBE Outcomes Successful transition in 2009-2010 NEDSS compliant systems (most reporting areas) Four streams of data (eRVCT, Commercial vendors, State-developed systems and NBS) merged  single flat file (SAS format) Data quality checks  enhanced HL7 messages

9. TM Lessons Learned Need to retain IT expertise at the TB Program level: Systems Analyst (10 years TB / 18 years IT) Database Admin(<1 year TB / 10+ years IT) Public Health Analyst (18 years TB) Helpdesk Support Specialist (>5 years TB) Shared responsibilities

10. TM The Steps to Transition Set Standards Gather Intelligence Implement Standards Tracking and Supporting

11. TM Transition Steps (Set Standards) Create Data Collection form (RVCT) with CSTE and OMB approval RVCT Form Mapping Guide Vocabulary Create Message Guide to support RVCT Create Standard Vocabulary to support RVCT

12. TM New York City WA Transition Option Status eRVCT Option - 16 OR CA AK HI AZNM TX OK KS CO UT NV ID MT WY NE SD ND MN WI IL IA MO AR LA MSALGA FL SC NC TN KY OH IN MI PA WV VA NY ME NH MA RI CT NJ MD DE PR Washington DC VT Transition Steps (Gather Intelligence) TB Surveillance Data Collection (Future) November 6, 2008 NBS Option - 16 Commercial Option - 12 Pacific Islands State-Developed Option - 16 VI

13. TM Transition Steps (Implement Standards) Implementing New Tools for States TB PAM within NBS eRVCT Rhapsody Case Notification Route Implementing Capability to Receive Data Implementing TB Message Validation Tool Implementing Capability to Combine TIMS with NEDSS

14. TM Implementing TB-PAM and eRVCT Gathering requirements and business processes User Testing of Data Entry and Messaging Beta Testing Support

15. TM Implementing Rhapsody TB Case Notification Route CSV File TB Case Notification Message

16. TM Implementing Capability to Receive Data TB Data Mart Gathering Requirements for Views Naming of Variables and use of standard abbreviations Testing

17. TM Implementing TB Message Validation Tool CVR Pilot Project Validate Messages Alerting of data received that meets specified conditions (MDR, XDR)

18. TM Implementing Capability to Combine TIMS with NEDSS

19. TM Transition Steps (Tracking and Supporting) TB Messaging Work Group Collaborated across CDC to establish a bi- weekly call to support states building TB Case Notification Messages Included HL7 experts, PHIN certification experts and PHIN-MS experts All share knowledge and experiences

20. TM Where We are Today 51 Reporting Areas are in Production with capability of sending NEDSS data to CDC 16 NBS locations 10 eRVCT locations 9 Commercial locations 16 State-developed locations All remaining (9) Reporting Areas intend to be sending NEDSS messages by August 1 eRVCT location 7 Commercial locations 1 State-developed locations

21. TM TODAY (Continued) Working out new business processes How are Reporting Areas notified when Messages fail Messages have validation errors Good messages received Implementing changes to current case counting processes Implementing changes to data completeness and quality processes