TM Vaccine Doses Administered Exercise (DAX) Discussion of Options 2 & 3: Submitting Aggregate Reports using the Web-Based User Interfaces of the CDC’s CRA System June 24, 2008 Presentation by: Immunization Services Division National Center for Immunization and Respiratory Diseases and Division of Emergency Preparedness and Response National Center for Public Health Informatics

TM 2 Agenda Learning Objectives Background DAX Summary Data Entry and Reporting Workflow Option 2 Details Option 3 Details Confirm Aggregate Report Details CDC Resources and Contacts Questions and Answers

TM 3 Learning Objectives Understand Options 2 & 3 for capturing aggregate counts in the CRA system Understand Project Area reporting of aggregate counts to CDC using the CRA system Understand the operational steps and decisions to be made for Options 2 & 3 Understand the CDC technical support available for Options 2 & 3

TM 4 Background The National Strategy for Pandemic Influenza: Implementation Plan calls for monitoring of the appropriate use of a scarce pandemic influenza vaccine To accomplish this, states/project areas will track vaccine doses administered and collect and aggregate minimum data elements and transmit weekly to CDC

TM 5 DAX Summary The 2007 pilot demonstrated project areas’ ability to collect and report to CDC and CRA’s technical capability to accept and aggregate data The 2008 exercise expands on this capability to test the following: Weekly reporting Increased volume Priority group tracking

TM 6 DAX Summary (continued) DAX 2008 Data Set Partner – from Project Area Valid Value List Event – DAX2008 Start Date – Beginning date of the reporting period End Date – Ending date of the reporting period Vaccine Type – from CVX codes for seasonal influenza vaccine Doses Administered – Aggregate count for each General Population Priority Group

TM 7 DAX Summary (continued) Report data weekly for four consecutive weeks from eight or more clinics during the timeframe of Oct. 1 – Dec. 31, 2008; fully successful criteria: Weekly reporting: aggregate reporting data is sent by Tuesday for the previous reporting week (Sunday through Saturday; MMWR week); for any four consecutive weeks Increased volume: data is from a minimum of eight clinics over the course of the four weeks Priority group tracking: each general population priority group is tracked

TM 8 Options for Aggregate Reporting to CDC Option 1: For states and project areas collecting data via an existing immunization information system (IIS) or other application, technical specifications were developed for three different data exchange formats: flat file (pipe- delimited), XML file, HL7 Option 2: For states and project areas collecting data manually, an aggregate reporting screen was added to CDC’s CRA application to allow direct data entry via a web browser Option 3: For states and project areas using CDC’s CRA application to collect patient level information, selected data elements will be automatically aggregated

TM 9 Data Entry and Aggregate Reporting Data Entry Specialist at clinic enters vaccine doses administered for the clinic Project Area POC reports the aggregate doses administered for the project area to CDC (by end of day – 11:59pm Tuesday following the week being reported) Doses administered data for clinic and/or person level is aggregated and displayed on screen Project Area POC with PHA rights confirms and reports the aggregate counts to CDC

TM 10 Option 2: Clinic Level Data Entry using CRA Web Form Summary of Option 2 Clinic staff collects summarized data for doses administered As clinics occur, the data entry staff enters counts via CRA’s web-based aggregate reporting user interface Counts are entered at the clinic level by vaccine type; product and lot are optional

TM 11 Option 2: Clinic Level Data Entry using CRA Web Form (continued) Process Considerations Determine who will enter information on-line Technical Considerations Staff entering data on-line must have access to the internet via web browser Staff accessing CRA must have a digital certificate

TM 12 Option 2: Responsibilities Clinic Level Enter aggregate data into CRA system for the clinic if using at clinic level Project Area Level Define and load clinics in CRA system Identify data entry staff for each clinic in CRA system Oversee responsibilities; will be able to see and edit entered data in CRA system Confirm and report aggregate data (entered by provider/local public health) to CDC CDC Store and secure entered data Create national reports

TM 13 Option 2: Aggregate Reporting Screen Shot

TM 14 Project Area Reporting CRA system will provide counts based on Project Area data entered Project Area POC confirms aggregate dose counts Confirmed counts are submitted to CDC

TM 15 Aggregate Count Confirmation Screen Shot

TM 16 Option 3: Patient Level Data Entry using CRA Summary of Option 3 Clinic staff collects patient level information locally Patient level data are entered into CRA (at minimum core data elements) Clinic may choose to enter additional patient level information

TM 17 Option 3: Patient Level Data Entry using CRA Process Considerations Determine who will collect and enter data and at what level of detail vaccination data will be collected CDC’s CRA system can collect detailed individual level information in addition to core data elements; additional elements are for Project Area use only

TM 18 Option 3: Patient Level Data Entry using CRA Technical Considerations Staff entering data on-line must have access to the internet via web browser Staff accessing CRA must have a digital certificate

TM 19 Option 3: Responsibilities Clinic Level Enter individual data into CRA system Project Area Level Define and load clinics in CRA system Identify data entry staff for each clinic in CRA system Oversee responsibilities; will be able to see and edit entered data in CRA system Confirm and report aggregate data (entered by provider/local public health) to CDC CDC Store and secure entered data Create national reports

TM 20 Option 3: Patient Level Data Collection Screen Shot

TM 21 Aggregate Count Confirmation Screen Shot

TM 22 CDC Technical Support Get access to the CRA Demo system ( contact the PHIN Help Desk Apply for an SDN Digital Certificate at for password contact the PHIN Help Desk Contact the CRA Help at to request access to the CRA Exchange area of CDC Team website

TM 23 Option 2 and 3: Action Items Identify a Point of Contact (POC) Confirm decision to use Option 2 or 3 Confirm all individuals entering data have digital certificates by August 29 Option 2 - Identify the method and process for aggregation by August 29

TM 24 Option 2 and 3: Action Items (continued) Reporting Week and Clinic Confirmation by September 12 Confirm the 4 week period for which the Project Area will participate in the exercise Minimum of 4 consecutive weeks Average of 2 clinics per week with a minimum of 8 total clinics

TM 25 Cities Readiness Initiative (CRI) Heads up Funding for continuation of the Public Health Emergency Preparedness (PHEP) Cooperative Agreement Interim Progress Report guidelines Using information collected through a sample of seasonal influenza vaccination clinics, each grantee will report to CDC data on vaccination doses administered The group of participating seasonal influenza vaccination clinics must include at least one in each CRI metropolitan statistical area and at least one in each of an equal number of non-CRI venues. The latter may be urban, suburban, exurban, or rural and are to be selected in consultation with your DSNS program consultant A list of CRI/MSA by states will be provided

TM 26 Phase I: Pre-Exercise Planning Apr-Sep 2008 CDCTasksCDCTasks DAX 2008 Task Expectations Phase II: Exercise Oct-Dec 2008 Phase III: Post-Exercise Jan-Mar 2009  Webinars-Orientation & Introduction  Webinars-Option specific; DAX updates; open Q&A; option specific final exercise preparations  Selection of POC  Conf. Calls-Individual project areas; follow up for Q&A  PHIN conference  Identify & submit option choice  Development & Deployment- Version 1.8 release  DAX-Receive clinical data from 62 project areas  Finalize & submit reporting weeks & clinic location (CRI)  Review option guide  Develop feedback questionnaire  Respond to feedback questionnaire  Develop After Action Report  Conf. Call-After action review exercise feedback  Obtain digital certificates  Briefings and conf. presentations  Participate in After Action Review  Submit seasonal influenza vaccine doses administered data to CDC  Exercise support & trouble shoot PATasksPATasks

TM 27 Points of Contact and Resources Charles Williams, CRA Team, Division of Emergency Preparedness and Response or Submit POC information and option choice Obtain access to CRA Exchange CRA Help General aggregate reporting questions and inquiries PHIN Help Desk Issuing and renewing digital certificates Getting access to CRA demonstration site Problem solving To get a copy of this presentation:

TM 28 Upcoming Webinars and Meetings DateEventTopic July 9Conference CallCRI Requirement and Open Q&A for Option 1 July 23Conference CallCRI Requirement and Open Q&A for Options 2 and 3 August 6Conference CallGeneral Information and Questions August 21-22Doses Administered and Safety Training Conference Doses Administered Reporting Training and 2008 Exercise August 24-28PHIN ConferencePublic Health Informatics: Collaboration at the Crossroads September 10WebinarExercise Overview and Refresher September 17WebinarRelease of CRA Version 1.8 October 1DAX 2008 Kickoff

TM 29 Questions?