Enhancement of the Communicable Disease Electronic Surveillance System with Syphilis Serology Tracking and Perinatal Hepatitis B Modules Hwa-Gan Chang Hwa-Gan Chang 1 Charleen Cox Charleen Cox 2 Mary Phillips Mary Phillips 1 Jacquelin Griffin Jacquelin Griffin 2 Perry Smith Perry Smith 1 1 New York State Department of Health 2 Keane, Inc

New York System Architecture New York System Architecture

Clinical Labs HL-7/ASCII/Web entry Hospital Emergency Departments ECLRS General Communicable Congenital Malformation HIV Lead STDTB State Program Areas Local Health Departments/ NYCDOH Health Commerce Network Internet Electronic Clinical Laboratory Reporting System (ECLRS) Public Health Lab Emergency Department Cancer Perinatal Hep B

New York Communicable Disease Electronic Surveillance System (CDESS) Upstate LHDs Paper Reports ECLRS CDESS Labs State/Regio n CD, TB, STD Hospital ICP

Methodology Project Charter Project Charter Objectives Objectives Mission Mission Scope Scope Risks Risks Project Team Project Team System Prospectus System Prospectus Project Definition Project Definition Business Requirements Business Requirements Security Requirements Security Requirements Screen Mock-ups Screen Mock-ups Use Cases Use Cases Technical Documentation Technical Documentation Technical Specifications Mapping documents Conversion business rules Database Model Test Plans Test Plans Test Scenarios Test Cases Pass/Fail Criteria Project Schedule Project Schedule

CDESS Estimated Volume Approximately 850 total CDESS users More than 70,000 new cases per year – –Approximately 800 new Syphilis Serology records per year. – –Approximately 300 new Perinatal Hepatitis births tracked per year

Syphilis Serology Tracking Background Serology cards are manually maintained by LHDs for each patient that has been tested or treated for Syphilis since 1976 Serology cards are manually maintained by LHDs for each patient that has been tested or treated for Syphilis since 1976 These serology cards are searched manually when a potential case is identified. The history captured on the serology cards is used to accurately stage the syphilis case. These serology cards are searched manually when a potential case is identified. The history captured on the serology cards is used to accurately stage the syphilis case. A patient may have serology cards in multiple jurisdictions. A patient may have serology cards in multiple jurisdictions.

Syphilis Serology Tracking Module Features Creates a patient-centric electronic registry of syphilis serology records Creates a patient-centric electronic registry of syphilis serology records Stores current and historical data in a single location Stores current and historical data in a single location Allows searching across counties for more accurate staging/reporting Allows searching across counties for more accurate staging/reporting Lab and treatment data can automatically be linked to the patient’s serology record Lab and treatment data can automatically be linked to the patient’s serology record

Syphilis Serology Tracking Data Flow

Process begins with a CDESS Case/Investigation Report

User Enters Serology Patient information

User reviews Lab and Treatment Data

Perinatal Hepatitis B Background Perinatal Hepatitis B data has been captured by NYS since 1987 on a local systemPerinatal Hepatitis B data has been captured by NYS since 1987 on a local system Identifies and tracks infants born to HBsAg- positive mothersIdentifies and tracks infants born to HBsAg- positive mothers Paper reports are generated and mailed to the LHDsPaper reports are generated and mailed to the LHDs LHDs report vaccination and post-vaccination testing back to the stateLHDs report vaccination and post-vaccination testing back to the state The state enters the information into the databaseThe state enters the information into the database

Perinatal Hepatitis B Module Features Eliminates the need to send paper reports between the state and LHDs Eliminates the need to send paper reports between the state and LHDs Provides LHDs electronic access Provides LHDs electronic access Allows searching for infant tracking records Allows searching for infant tracking records Provides a link between the index case (mother) and the infant(s) being tracked Provides a link between the index case (mother) and the infant(s) being tracked Provides a summary page of all infants being tracked for an HBsAg-positive mother Provides a summary page of all infants being tracked for an HBsAg-positive mother Allows users to generate reports Allows users to generate reports

Perinatal Hepatitis B Module Data Flow

Perinatal Hepatitis B – Infant Tracking

CDESS Structural Overview

Future CDESS Projects Contact Tracing Contact Tracing Reporting Facility Reporting Facility Tuberculosis program area module Tuberculosis program area module Case notification using PHIN messaging Case notification using PHIN messaging