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An Assessment of Information Exchange Practices, Challenges, and Opportunities to Support US Disease Surveillance in 3 States

Garcia, Macarena C., DrPH, MIS; Garrett, Nedra Y., MS; Singletary, Vivian, MBA; Brown, Sheereen, MS; Hennessy-Burt, Tamara, MS; Haney, Gillian, MA; Link, Kimberly, ScM; Tripp, Jennifer, MPH, MT (ASCP), RN; Mac Kenzie, William R., MD; Yoon, Paula, ScD, MPH

Journal of Public Health Management and Practice: November/December 2018 - Volume 24 - Issue 6 - p 546–553
doi: 10.1097/PHH.0000000000000625
Research Reports: Research Brief Report

Background: State and local public health agencies collect and use surveillance data to identify outbreaks, track cases, investigate causes, and implement measures to protect the public's health through various surveillance systems and data exchange practices.

Purpose: The purpose of this assessment was to better understand current practices at state and local public health agencies for collecting, managing, processing, reporting, and exchanging notifiable disease surveillance information.

Methods: Over an 18-month period (January 2014-June 2015), we evaluated the process of data exchange between surveillance systems, reporting burdens, and challenges within 3 states (California, Idaho, and Massachusetts) that were using 3 different reporting systems.

Results: All 3 states use a combination of paper-based and electronic information systems for managing and exchanging data on reportable conditions within the state. The flow of data from local jurisdictions to the state health departments varies considerably. When state and local information systems are not interoperable, manual duplicative data entry and other work-arounds are often required. The results of the assessment show the complexity of disease reporting at the state and local levels and the multiple systems, processes, and resources engaged in preparing, processing, and transmitting data that limit interoperability and decrease efficiency.

Conclusions: Through this structured assessment, the Centers for Disease Control and Prevention (CDC) has a better understanding of the complexities for surveillance of using commercial off-the-shelf data systems (California and Massachusetts), and CDC-developed National Electronic Disease Surveillance System Base System. More efficient data exchange and use of data will help facilitate interoperability between National Notifiable Diseases Surveillance Systems.

Office of the Director (Dr Garcia and Ms Garrett), US Public Health Services (Dr Mac Kenzie), and Division of Health Informatics and Surveillance (Dr Yoon), Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia; Public Health Informatics Institute, Atlanta, Georgia (Mss Singletary and Brown); Communicable Disease and Emergency Response Branch, Division of Communicable Disease Control, California Department of Public Health, Sacramento, California (Ms Hennessy-Burt); Bureau of Infectious Disease, Integrated Surveillance and Informatics Services, Massachusetts Department of Public Health, Boston, Massachusetts (Ms Haney); Division of Community and Environmental Health, Office of Communicable Disease Control, Central District Health Department, Boise, Idaho (Ms Link); and Southwest District Health Department, Caldwell, Idaho (Ms Tripp).

Correspondence: Macarena C. Garcia, DrPH, MIS, Office of the Director, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329 (mcgarcia@cdc.gov).

This study is funded by CDC Cooperative Agreement CDC-RFA-OT13-1302, Building Capacity of the Public Health System to Improve Population Health through National, Nonprofit Organizations.

The authors acknowledge the following individuals: Michael F. Iademarco, MD, MPH, Director, Captain, US Public Health Services, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, Georgia; David A. Ross, ScD, President and CEO, Task Force for Global Health; Marisa Moore, MD, MPH, Epidemiologist, Captain, US Public Health Service, Tuberculosis Control and Refugee Health, County of San Diego Health & Human Services Agency; Jeffrey Johnson, Senior Epidemiologist, San Diego County Health & Human Services Agency; Marjorie Richardson, STD Surveillance Team Epidemiologist, San Diego County Health & Human Services Agency; Michael Bursaw, Program Manager for the HIV/AIDS Surveillance Unit, San Diego County Health & Human Services Agency; Jake Pry, Epidemiologist, Sacramento County Disease Control and Epidemiology Unit; Sita Smith, Massachusetts Department of Public Health, Bureau of Infectious Disease, Integrated Surveillance and Informatics Services (ISIS); Susan Kilroy-Ames, Cambridge Health Alliance; Raemi Nolevanko, Epidemiologist, Southwest Health District, Idaho; Randi Pedersen, Epidemiologist, Southwest Health District, Idaho; Lindsay Haskell, Central District Health Department, Idaho; Gladys Goodman, Central District Health Department, Idaho; Sarah Correll, Central District Health Department, Idaho; Brandon Atkins, Central District Health Department, Idaho; Melina Guzman, Southwest District Health, Idaho; and Jazmine Victoria, Southwest District Health, Idaho.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (http://www.JPHMP.com).

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