Standards

Timeliness of reports sent by laboratories and providers is a continuous challenge for disease surveillance and management. Public health organizations often collect communicable disease reports with various degrees of timeliness raising the concern about the delay in patient information received. Timely reports are beneficial to accurately evaluate community health needs and investigate disease outbreaks. According to Indiana state law, chlamydia reports are required to be sent to public health within 3 days after a positive test result confirmation. Therefore, laboratories and providers must be accountable and comply with regulation to ensure accurate data quality of disease assessment.

Objective

To analyze the time delay between a chlamydia positive test diagnosis and when a laboratory and/or a provider sends a report to a local public health department.

The US Department of Health and Human Services has mandated that after October 1, 2015, all HIPAA covered entities must transition from using International Classification of Diseases version 9 (ICD- 9) codes to using version 10 (ICD-10) codes (www.cms.gov). This will impact public health surveillance entities that receive, analyze, and report ICD-9 encoded data. Public health agencies will need to modify existing database structures, extraction rules, and messaging guides, as well as syndrome definitions and underlying analytics, statistical methodologies, and business rules. Implementation challenges include resources, funding, workforce capabilities, and time constraints for code translation and syndrome reclassification.

Objective

To describe the process undertaken to translate syndromic surveillance syndromes and sub-syndromes from ICD-9 diagnostic codes to ICD-10 codes and how these translations can be used to improve syndromic surveillance practice.

On January 24, 2014, the Public Health Accreditation Board (PHAB) released, to the public, its Standards & Measures Version 1.5 guidance document for voluntary public health department accreditation. Specifically, Standard 1.2 of the guidance encompasses data collection. Two measures of Standard 1.2 stipulate the requirements of surveillance and their purposes in the context of PHAB accreditation. First, according to Measure 1.2.1A: 24/7 surveillance system or set of program surveillance systems, the purpose of the measure is to assess the health department’s process for collecting and managing health data for public health surveillance. Second, according to Measure 1.2.2A: Communicate with Surveillance Sites, the purpose of the measure is to assess the health department’s regular contact with sites who report surveillance data to the health department. Health departments that are applying for voluntary accreditation through PHAB beginning July 1, 2014, must adhere to the current Standards & Measures Version 1.5 guidance document. Given the recent effective date of the application period under Standards & Measures Version 1.5, there are very few, if any, examples of required documentation that state health departments (SHDs) must submit in order to meet each public health surveillancespecific measure. Accreditation document libraries provided examples for health department applicants under Standards & Measures Version 1.0. Because they are no longer applicable to accreditation, examples pertaining to Standards & Measures Version 1.0 have been removed from many documentation library websites.

Objective

To specify the pertinent roles of public health surveillance in meeting documentation requirements for voluntary state health department accreditation.

This roundtable provided a forum for a diverse set of representatives from the local, state, federal and international public health care sectors to share tools, resources, experiences, and promising practices regarding the potential impact of the transition on their surveillance activities. This forum will promote the sharing of lessons learned, foster collaborations, and facilitate the reuse of existing resources without having to 'reinvent the wheel.' It is hope that this roundtable will lay the ground-work for a more formal, collaborative, and sustainable venue within ISDS to aid in preparing the public health surveillance community for the coming ICD-9/10 CM transition.

Outbreak Investigations course consisted to a series of 8 online modules, covering: •Confirm that an outbreak is occurring and confirm diagnosis •Case definition •Descriptive Epidemiology •Hypothesis Generation •Analytic Epidemiology •Preliminary control and Prevention •Communication of findings •Establishing disease surveillance and monitoring The online modules were followed by live webinars, taught by the instructors who wrote each unit of the online webinar. Finally, select epidemiologists from Veterinary Services were invited to a 3-day classroom course, to collaborate with other team members and practice outbreak detection, surveillance and control. Three scenarios were created to highlight economic impact, severe consequences of an uncontrolled outbreak, OneHealth approach and the collaboration needed during a zoonotic disease outbreak.

Objective

The United States Department of Agriculture (USDA) created a new course in 2013 to meet needs of the veterinary epidemiologists within the Veterinary Services (VS) division. The objective of this training was to provide a standard framework to investigate animal disease outbreaks, and apply practical solutions. VS has expertise in animal surveillance, this training course demonstrated how to incorporate the fundamentals of surveillance into an outbreak scenario. The goal of course was to give epidemiologist skills and practice to more quickly and efficiently conduct an investigation, allow rapid identification of a cause, apply control measures, and limit economic and health impacts of a disease.

Lung cancer is the leading cause of cancer death in the U.S. with radon exposure as the second leading cause of lung cancer after smoking and the number one cause of lung cancer among nonsmokers. The Environmental Protection Agency (EPA) estimates that one in fifteen homes nationwide has elevated radon levels. Although public outreach efforts promote radon testing and subsequent mitigation when unsafe levels are found, data are non-standardized largely because of varying regulations among states, making targeted public health actions challenging. In accordance with the Federal Radon Action Plan to demonstrate results of radon risk reduction, EPA is collaborating with CDC’s Environmental Public Health Tracking Program. The Tracking Program has existing relationships with state and local partners to provide various environmental and health data, an established process for managing the data, and robust tools to analyze and visualize the data that are made publicly accessible via a web-based system (Tracking Network).

Objective

Test the feasibility of a publicly accessible national radon database by conducting a pilot project to standardize previously nonsystemized, uncoordinated state and local health department radon data sources into a nationally consistent radon information resource.

The PHCP is a community-led initiative to provide shared infrastructure, services, and applications to the public health community as solutions for complex public health informatics problems. The project has progressed by establishing a governance structure led by an executive committee representative of the public health practice community. The executive committee has established the strategic path for the continued development of the PHCP and prioritized eCR as the initial use case for implementation.

Objective

To inform the community on the progress of electronic case reporting (eCR) utilizing the shared infrastructure and applications of the Public Health Community Platform (PHCP).