Data Verification_ Secured Correspondence Systems_ and Other by hcj


									     Data Verification, Secured
Correspondence Systems, and Other
 Issues of Inter-jurisdictional Data

      Lyle R. Petersen, M.D., M.P.H.
      Two Objectives of National
        Surveillance Requiring
    Interjurisdictional Data Sharing

• Further develop national public health
  strategies for WN virus surveillance,
  prevention, and control.
• Provide national and regional information to
  public health officials, elected government
  officials, and the public.
              Data Security Issues
• State and local authorities control timing of data
• Via secure web site, early access to data to ensure
  that data released by CDC are correct
• Protect confidentiality:
   – Personal identifiers not collected for surveillance purposes
   – Localizing information more specific than county not
     released by CDC
   – Freedom of Information Act: can protect individuals but not
         Data Flow and Timing, 2000
                           Daily (Numerator): Phone/Email/FAX
     Raw data
                           Weekly (Denominator): SDN
State subset of            Weekly (Wed/Thurs)
 CDC database
   Verification            Weekly (Thurs)
  OK to publish
                           Weekly (Fridays)
    Publication            Weekly (Tuesdays)

              National Atlas

• Public release of numerator data by states
  very rapid
• No premature release of information by CDC
• High degree of accuracy
• Newsworthy surveillance events:
  – New counties (mosquitoes, mammals, birds,
  – Any human case
          Need for Improvement

• Phone-in reporting to CDC became overwhelmed
  (esp. for dead birds)
• Verification slow and cumbersome, particularly for
  high frequency events
• Too many data points to be verified
• “OK to publish” check-off redundant
• Too many data fields in numerator
• National data in National Atlas – minimum 7 days old
  (good for examining trends, too slow to react to
Need to Better Define Avian Morbidity/Mortality
        Denominator Data Collection

                      Positive (numerator)
                      Submitted for testing

                      Crows and other species

       Weekly         •Overlapping groups
                      •Too many data points
                      •Submitted not equal to tested
                      •Misalignment of weeks
 Recommendations: Data Collection
     and Release (Numerator)
• Limit number of forwarded data fields
• Automate reporting
• Birds and mosquitoes
   –   Eliminate verification step
   –   Eliminate “OK to publish” designation
   –   Data returned to states within 24 hours of receipt
   –   Data considered verified and ready for release within 48
       hours of receipt unless CDC informed otherwise
• Horses, other mammals, persons
   – Same procedure as in 2000
   – Eliminate “OK to publish” designation
  Recommended Avian Morbidity/Mortality
      Denominator Data Collection

                                       Positive (numerator)
                                       Number tested


                                       Crows and other species

Weekly (should we try to align the weeks?)
 Recommendations: Data Collection
    and Release (Denominator)
• Eliminate verification step
• Eliminate “OK to publish” designation
• Consider transferring data from birds and
  mosquitoes that test negative so the
  proportion positive by week of collection can
  be computed
• Better definition of what to report; more
  training and oversight
 Recommendations: Data Collection
         and Release
• Jurisdictions must identify an IT point person
  responsible for electronic transfer and receipt
  of information
    Interjurisdictional Communication

•   Wednesday conference calls (great)
•   Web board (total failure)
•   Notification by CDC of significant events (mixed)
•   Notification by states of significant events (mixed)
•   MMWR (good)
•   National Atlas (good for examining trends, needs to
    be supplemented by other systems for very timely
 Recommendations: Communication

• Interjurisdictional communication
   –   Continue weekly phone calls as necessary
   –   Epi-X
   –   MMWR
   –   Summary on CDC web site
   –   National Atlas
• Communication to public
   –   Primarily a state and local health dept. responsibility
   –   MMWR
   –   National Atlas
   –   Summary on CDC web site with links to state sites for more
       detailed information

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