1. Baltimore Update: SSuN, 2009

2. Challenges in implementation Clinic-based dataset: – Existing clinic data system (Insight™) – Minimal barriers to electronic data capture and export – Greater challenge: Stability of personnel since initiation of grant Population-level GC data – Personnel – Some “soft” resistance on part of supervisory field operations staff

3. Successes in implementation Population-level GC data – Staff was recruited and trained (Sept 2009) – Initial completion rates for interview > 70% (first 2 months)

4. Use of SSuN to Inform Program Evaluating EPT experience and re-infection rates in clinic (early)

5. GC population-level data: Procedures Reported GC cases entered into STD*MIS (routine) List generated from STD*MIS for 1 week interval (end date 2 weeks prior) – 1/3 selected using randomization.com application, corresponding numbers applied to list from STD*MIS – These 1/3 are chosen for interview

6. GC population-level data: Procedures, cont Clinical data (treatment, etc) abstracted from provider morbidity reporting if available, or from STD clinic records Persons on list contacted by phone (or field visit rarely) by public health investigator under direction of DIS supervisor Interview to collect expanded behavioral data Data entry into Access database Data file re-merged with STD*MIS, then converted into SAS Cases “closed” if report date > 60 days without interview concluding Plans to change random selection to 1/6 of reported GC morbidity for December 2009

7. Patient visits clinic Demographic info entered into Insight by clinic staff Exam, risk behaviors, labs, diagnosis, treatment entered into Insight by clinician Data stored on SQL server (Insight) Conduct Insight queries: Core, diagnostic, clinical/lab data Export data to Excel (.csv) Import data into Stata (use StatTransfer) Clean data in Stata: Run contingency tests (use Stata program) Edit data in Stata Format to SAS file Submit to CDC using SDN certificate or FTP website Clinic-based Surveillance Data GC cases reported to BCHD (STD*MIS) Random selection made from population of Baltimore City gonorrhea cases Some information on questionnaire filled out using Insight database PID status collected-Insight database (notes section), ER reports or notes section in STD*MIS GC test type information collected-Insight database or lab reports faxed to BCHD Questionnaire data entered into Access database (SSuNInterviewdb) Personal interview conducted to collect remaining information Transfer Access file to Stata using StatTransfer Conduct data coding tests with Stata program Edit errors in Access database Transfer cleaned Access database to SAS Transfer to CDC using SDN transfer certificate or FTP website Population-based GC Data