Integrating Workflow Processes With A Reportable Disease Data

Integrating Workflow Processes With A Reportable Disease Data Management System: New Jersey's Experiences Simi Octania-Pole, Ph. D New Jersey Department of Health and Senior Services

Learning Objective Describe the importance of integrating workflow processes with analysis, visualization and reporting (AVR) tools in designing New Jersey’s Communicable Disease Reporting and Surveillance System (CDRSS)

New Jersey n Population: 8. 7 million (2006 U. S. Census) n 21 counties n 566 municipalities n 114 local health departments n 74 acute care facilities

CDRSS Overview n Patient-centric, Web-enabled, PHIN-compliant n Integrated ELR n Extensive fields for case and outbreak management n Integrated AVR tools n Modules for reporting aggregate data for Influenza-like Illness and Antimicrobial Resistance n Built-in administrative flexibility to add and manage diseases, dropdown values, reporting criteria, etc.

The Stakeholders Over 1200 users representing the following n NJ DHSS – nurses, epidemiologists, clerks and lab staff n LHD – health officers, nurses, epidemiologists and clerks n Hospital – Infection control professionals (ICPs), lab staff n Commercial Labs

AVR Tools n Tables and lists n Maps n Charts / Graphs

Utilization of Reports n Disease / case management n Resource management n Grants / funding / presentations n Data analysis / research

Types of Reports

Disease / Case Management Streamline workflow n Through lists Access to cases based on jurisdiction and/or role in public health response n Different tabs to reflect progress of follow up n Multiple search options n n Reports (over 175 options) n Line lists n Case details n Summary

Disclaimer All data displayed in this presentation are test data as entered into the CDRSS Training site and do NOT reflect actual users, cases or counts.

Resource Management n Staff management n usage reports – including cases created and updated by users n time taken to complete investigations n audit trail for case management n frequency of logging into application n cases created manually versus received electronically

Grants / Funding / Presentations n Standardized reports and graphs n County and municipal level disease summaries n Temporal comparisons n Compliance n Custom maps showing distribution of cases

Using a report for compliance Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5 Hospital 6 Hosp Hosp 8/26/2004 1/26/2004 9/28/2002 3/12/2006 8/26/2004 6/11/2007 14 6 8 7 5 12 83 1 110 188 67 217 55 0 28 6 12 34 64 0 3 4 0 57 Report highlights that Hospital 2 and 4 do not enter their reportable diseases in CDRSS 11 22 12 249 6 4

Data Analysis / Research n Export data n Almost all reports can be exported to other formats n Users can select fields to generate their own file for use with other statistical software n Archived database n A “point in time” database is available to generate statistics comparable to those published in MMWR

Use of GIS n All cases are geocoded and assigned to appropriate jurisdiction Exact address match n If not available, locate address manually on the map, or use one of the following n n County centroid Zipcode centroid Municipality centroid n Case distribution n Contact mapping

Impact of GIS on Improving Workflow Same city name and ZIPcode – one reporting jurisdiction?

Same city name and ZIP code – one reporting jurisdiction?

Same city name and ZIPcode – Eight Different Health Departments! Municipality Franklin Twp County Somerset Health Department Franklin Twp HD Montgomery Twp Montgomery HD South Brunswick HD Middlesex Plainsboro Twp Middlesex County HD Lawrence Twp HD West Windsor Twp West Windsor HD Princeton Boro Princeton Twp Hopewell Twp Mercer Princeton Regional Health Commission Hopewell HD

Lessons Learned § Good AVR tools are essential towards building a dedicated user base § Effective utilization of AVR tools creates a self- generating “continuous improvement process”

Acknowledgments n n n n n Dr. Corey Robertson, MD Marlene Bednarczyk, MSQSM CDRSS Steering Committee NJDHSS CDS NJDHSS OITS Centers for Disease Control and Prevention NJ local health departments NJ acute care facilities NJ hospital and commercial laboratories

Contact Information Simi. Octania-Pole@doh. state. nj. us Phone: (609) 588 3121 To view CDRSS (Training site) http: //cdrs-train. doh. state. nj. us User ID – PHINuser 1 Password - PHINuser 1