1. Surveillance: From Patient to CDC
Miranda Fanning
TB/HIV/STD Epidemiology and Surveillance
Group Manager

2. Overview Case information flow Required information to report a case
Identifying unreported potential cases
In this presentation, we will help connect the genotyping dots by discussing how surveillance reporting plays into genotype information. We are going to go over case information flow and required information to report cases. Then Robin will discuss how to identify unreported potential cases.

3. Surveillance Data Collection and Reporting
Case identified locally and patient information collected
Lab Report alerts Central Office to case
RVCT Form completed and sent to Central Office
RVCT Form reviewed, information verified and entered into TB-PAM; Genotype accession number entered into TB-PAM
Case information transmitted to CDC
We are going to discuss how surveillance information is collected, captured, entered and transmitted to the CDC. The purpose of discussing this is so that you can understand the vital role you play in reporting case information that is used to for many functions, including genotyping. Cases are identified and patient information is collected locally. Lab reports are also received at central office that alert us to potential cases. RVCT forms are completed and sent to central office. We then review the RVCT information, make sure that all variables are complete and necessary supporting information is available and we enter the case into TB-PAM. Weekly, we enter genotyping accession numbers into already reported TB-PAM cases. Case information is then transmitted to the CDC.

4. How Surveillance fits into the Genotyping information flow
Case identified locally and patient information collected
Lab Report alerts Central Office to case
RVCT Form completed and sent to Central Office
RVCT Form reviewed, information verified and entered into TB-PAM; Genotype accession number entered into TB-PAM
Case information transmitted to CDC
Culture Isolate or raw specimen sent to DSHS lab
Transmitted to Michigan lab/CDC for genotyping
Here you can see how the laboratory process connects to the surveillance process. We enter the unique identifier for the genotyped lab result into TB PAM for already reported cases, but we have to have the case reported before we can connect the two processes. There are many steps in the surveillance process that must happen before the genotype accession number can be entered into TB PAM
Genotype with DSHS and Michigan Accession numbers in TB-GIMS

5. Importance of Timely Reporting
Cannot link RVCT case to genotype without required RVCT variables
Will not be able to use genotyping information appropriately without reported case information
Need your help!
We cannot link cases to genotypes without the required RVCT variables. We have to have the specific variables before we can assign an state case number, enter the case information and transmit it to the CDC. We will not be able to use genotyping information without reported case information. This is where we need your help.

6. Required RVCT Data Elements
Complete name
Social security number
if they have a ssn but is unknown
if undocumented immigrant
Sex
Date of birth
Race and ethnicity
Country of origin; If non U.S., date of entry into the U.S. …
For each case, we must have the following variables…

7. Required RVCT Data Elements
Address, city, county, zip-code with 4 digit code and if in or outside city limits; If diagnosed while in a facility or shelter, the name of the facility or shelter (Include address verification)
Criteria for confirmed case of TB must be documented on the case verification report.
Copy of Non DSHS lab report if case is a lab confirmed case and susceptibilities
Criteria for clinical case
Criteria for clinical case by provider diagnosis …

8. CDC Case Reporting- Central Office Process
RVCT Form Reviewed
RVCT Entered into TBPAM
Case reviewed and notified
Case sent to the CDC
Once we get the RVCT form, we review it to ensure that the required data elements are present, address has been verified and appropriate laboratory or clinical information is present. If information is missing, surveillance staff will contact local/regional health department to get the missing information. Then the RVCT form is entered in TB-Pam. Cases are reviewed and notified, which means they can be transmitted to the CDC.

9. CDC Reporting Daily, case information is transmitted to CDC
Processed by CDC weekly
Proportion of cases in TB-PAM with genotype accession number evaluated by CDC
Daily, case information is transmitted to the CDC and cases are processed weekly. The portion of cases in TBPAM with a genotype accession number are evaluated by the CDC and we are assessed as a state on how we are meeting the standards.

10. Potential Cases pending Reporting
Lab reports for potential cases in TB-PAM
Daily, assigned to jurisdictions for review and follow up
Provides queue for registry staff and program managers to identify outstanding cases
We’ve developed a way to help you identify cases that have not been reported. All lab reports that come in for potential cases are reviewed in TB-PAM and assigned to a registry for follow up. This provides you with a queue to identify outstanding cases, which helps to ensure that all genotyped cases are reported by the time we receive the genotyping results. Currently approximately 70% of cases are reported before the genotyping results come in. Robin is now going to demonstrate how you can view potential cases in your queue.

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12. Dashboard
Dashboard

19. Questions