TM 1 Countermeasure and Response Administration Working Group Webinar Webinar Presented July 30, 2008 Jeanne Tropper, MS, MPH & CRA Development Team Division of Emergency Preparedness and Response National Center for Public Health Informatics

TM 2 Agenda Purpose Background of CRA V1.8 New Features and Demonstration Question and Answer Discussion of V1.9 Topics Question and Answer CRA Working Group Organization and Schedule

TM 3 Purpose Foundation for All Hazards support near completion V1.9 likely last release before migrating to open source (OS) environment; closer alignment with OMS and Epi Info ™ Formalize process for prioritizing development of final release Position CRA to move to Outbreak Management Community of Practice (CoP) governance structure

TM 4 What is CRA? Genesis was Pre-Event Vaccination System (PVS) for national smallpox vaccination campaign Capability to support mass tracking during an event System has since evolved to support any countermeasure, any event; may include medical interventions such as vaccinations, pharmaceuticals and non-medical interventions such as patient isolation and quarantine or social distancing measures Includes the ability to track both detail (person level) and aggregate counts of countermeasures

TM 5 Implementation Options Centralized implementation – application is centrally located and managed by CDC; accessible using any standard web browser in conjunction with a CDC issued digital certificate Offline implementation - new with V1.7, CRA may be deployed offline on a stand-alone basis

TM 6 What is New with CRA? V1.8 due for release September 15, 2008 Aggregate Group & Reporting Enhancements (with Data Exchange) Priority groups National reporting Adverse Event Support Patient Follow-up Event Reports/Data Extracts Enhancements Sub-jurisdiction Support User-Defined Fields Support

TM 7 Definitions Countermeasure – intervention taken to help prevent and/or slow the spread of disease; countermeasures may include medical interventions such as vaccinations, pharmaceuticals and non-medical interventions such as patient isolation and quarantine Event – public health programs or emergency responses that require the administration of countermeasures User Roles – CRA has role based user access; the user can only access system functions appropriate to their role; two roles Public Health Administrator (PHA) Data Entry Specialist (DES) Aggregate Reporting – CRA has updated to support project areas reporting a subset of data to the CDC; the capability was established to support vaccine doses administered during a pandemic; however, it could be applied to any situation

TM 8 Table Patients Exiting POD Medical Counseling Area Table Mental Health Area Meds Dispensing / Vaccination Area - Staff- Patient 6 12 Table # - Number of stations Medical Screening Area CRA Data Entry Station Yes Meds/ Vaccination No Meds/ Vaccination Routine Door Patients Enter POD Door POD Patient Flow Table LEGEND Door Special

TM 9 Anthrax Scenario Multi-city event with affected populations in Washington, DC, New York City and Florida Scope of attack unknown; post exposure prophylaxis advised Central dispensing center established Emergency supply of antimicrobials ordered

TM 10 CRA Demonstration Anthrax Event in Washington, DC Demonstrate person data entry process Data entry of patient countermeasure Data entry of patient registration Demonstrate patient import feature – mail handlers

TM 11 Teen Vaccination Scenario Campaign to administer vaccines to pre-teens and teens in Long Beach School System Vaccination centers established in three middle schools CRA used for follow-up with students receiving HPV vaccine

TM 12 CRA Demonstration Teen Vaccination Event Demonstrate data entry of vaccine with follow-up dose schedule Demonstrate process to record adverse event Demonstrate event set up and ability to customize screens View follow-up configuration Add user defined field

TM 13 CRA Future Development Topics Head of Household Dispensing Look at all household dispensing options; group patients by family Alternate Data Entry Use barcode scanners, handwriting recognition; allow multiple data entry points, such as intake and dispensing; allow use of CRA on handheld devices Ability to Exchange Data with Other PH Systems including but not limited to Immunization Registries, Surveillance, Outbreak Management Systems Aggregate and line listed bi-directional data exchange in multiple formats

TM 14 CRA Future Development Topics, Continued Population Health Management Provide for import of population registries - nursing homes, hospital staff, EMS, etc; track denominator data; patient de- duplication/merge Data Elements for Patient Intake/Screening Risk factors; prior and current medical conditions; contraindications specific to countermeasures of interest CRA, Epi-Info, OMS Integration – what form should it take Bi-directional data exchange among applications; use standard architecture; same look and feel of applications; developing user-defined variables/questionnaires/forms

TM 15 CRA Future Development Topics, Continued Support Linkages with Strategic National Stockpile and Other Inventory Tracking Systems Support linkages with inventory systems; deployment of CRA with SNS Push packs preloaded with countermeasure information Analysis, Visualization and Reporting GIS capability; add query function; access to data entered into online and offline CRA; add staff management reports, duplicate identification, clinic and sub jurisdiction countermeasure administration, etc; print user record prior to countermeasure dispensing

TM 16 CRA Future Development Topics, Continued Provide a Patient Consent Form Document permission for countermeasure administration, follow-up, tracking and Epi research Decentralized Deployment Export data from off line installations to CDC and other localities; preload user, organization, and event data through import or batch entry; automate updates of offline installations; enhance offline system security ; enhance data encryption ; offer offline Web access and standalone access

TM 17 CRA Working Group Organization Development of Working Group Charter Generation of meeting minutes Development of committees Becoming a part of the Outbreak Management CoP CRA Working Group Webinar August 13, 2008 Workshop at PHIN Conference Tuesday, August 26, 7 am Review prioritized enhancements User feedback in focused areas, e.g., reporting, person-level data entry, other

TM 18 Getting Started with CRA Consider using during an exercise Demonstration version will be available for partner “try outs” CRA training available PHIN Help Desk first line of contact for accessing CRA Telephone : 8 AM to 8 PM EST