TM Vaccine Doses Administered Exercise (DAX) Discussion of Option 1: Data Exchange Using CDC’s CRA System and State Immunization Information (IIS) or Other Existing Systems June 11, 2008 Presentation by: Immunization Services Division National Center for Immunization and Respiratory Diseases and Division of Emergency Preparedness and Response National Center for Public Health Informatics

TM 2 Agenda Learning Objectives Background DAX Summary Aggregate Reporting Options Details on Option 1 of CRA System CDC Resources and Contacts Questions and Answers

TM 3 Learning Objectives Understand Option 1 and the various formats that may be used to report to CRA system Understand the operational steps and decisions to be made for Option 1 Understand the CDC technical support available for Option 1 of CRA system for aggregate reporting

TM 4 Background The National Strategy for Pandemic Influenza: Implementation Plan calls for monitoring of the appropriate use of a scarce pandemic influenza vaccine To accomplish this, states/project areas will track vaccine doses administered and collect and aggregate minimum data elements and transmit weekly to CDC

TM 5 DAX Summary The 2007 pilot demonstrated project areas’ ability to collect and report to CDC and CRA’s technical capability to accept and aggregate data The 2008 exercise expands on this capability to test the following: Weekly reporting Increased volume Priority group tracking

TM 6 DAX Summary Report data weekly for four consecutive weeks from eight or more clinics during the timeframe of Oct. 1 – Dec. 31, 2008; fully successful criteria: Weekly reporting: aggregate reporting data is sent by Tuesday for the previous reporting week (Sunday through Saturday; MMWR week); for any four consecutive weeks Increased volume: data is from a minimum of eight clinics over the course of the four weeks Priority group tracking: each general population priority group is tracked

TM 7 Options for Aggregate Reporting to CDC Option 1: For states and project areas collecting data via an existing immunization information system (IIS) or other application, technical specifications were developed for three different data exchange formats: flat file (pipe- delimited), XML file, HL7 Option 2: For states and project areas collecting data manually, an aggregate reporting screen was added to CDC’s CRA application to allow direct data entry via a web browser Option 3: For states and project areas using CDC’s CRA application to collect patient level information, selected data elements will be automatically aggregated

TM 8 Option 1: Data Exchange Summary Healthcare provider collects and maintains patient- level information locally and submits selected data to the IIS or other application The state submits aggregate data to CDC’s CRA system on a weekly basis via Immunization Information System or other application using one of three data exchange formats: Flat file (pipe-delimited) OR Extensible Markup Language (XML) file OR Health Level Seven (HL7) Version 2.5

TM 9 Option 1: Data Exchange (continued) Process Considerations What level of vaccination data and by whom it will be collected must be determined; at minimum, core data elements must be collected Aggregate data exchange must be consolidated at the project area prior to submission to CDC

TM 10 Option 1: Data Exchange (continued) Technical Considerations Local application should have capability to collect core data elements Core data elements should be extracted and put into one of three formats following the Data Exchange Specification for Pandemic Influenza Aggregate Report Transport mechanism should be determined and consistent with CDC PHIN standards CDC SDN Digital certificates must be in place for access and transfer to CRA

TM 11 Option 1: Data Exchange (continued) Transport Mechanism Considerations If using ebXML as a transport mechanism: Obtain and register a Party ID with CDC-CRA CRA will facilitate obtaining the Party ID PHINMS is available for project area installation; CRA will facilitate connecting the project area with PHINMS technical assistance

TM 12 Option 1: Data Exchange (continued) DAX 2008 Data Set Partner – from Project Area Valid Value List Event – DAX2008 Start Date – Beginning date of the reporting period End Date – Ending date of the reporting period Vaccine Type – from CVX codes for seasonal influenza vaccine Doses Administered – Aggregate count for each General Population Priority Group

TM 13 Option 1: Data Exchange (continued) Guidelines for Reporting Aggregate Data Each project area sending data to the CRA system is responsible for submitting one set of counts for each reporting period that aggregates all the doses administered for the eight exercise clinics in the project area Reporting is required for each reporting period during the event, even if no doses were administered Reporting period is based on the MMWR week; defined as Sunday through Saturday Reporting is required by close of business on the Tuesday following the end of the reporting period

TM 14 Option 1: Data Exchange (continued) Full Replacement of Aggregate Reports Full replacement of all aggregate counts already submitted along with the new aggregate counts is required for each reporting period Aggregate counts are replaced based on a match to the partner, event, start date, end date, and vaccine type Each week, submit the counts for the new week plus the counts for each previous week

TM 15 Option 1: Data Exchange (continued) Aggregate Reporting Full Replace Doses Administered per Week Week 1 – Doses Administered Week 2 – Doses Administered Week 3 – Doses Administered Week 4 – Doses Administered Week 1 Report 100 Week 2 Report 105 (week 1 data updated with 5 more doses 250 Week 3 Report 105 (no change from previous week) 250 (no change from previous week) 100 Week 4 Report 105 (no change) 200 (week 2 data updated with 50 fewer doses) 100 (no change) 375

TM 16 CDC Technical Support Download the Data Exchange Specification for Pandemic Influenza Aggregate Report document from the CRA PHIN website ( services/cra/2008Exercise.html) services/cra/2008Exercise.html Get access to the CRA Demo system ( contact the PHIN Help Desk Apply for an SDN Digital Certificate at for password contact the PHIN Help Desk

TM 17 Option 1: Action Items Identify a Point of Contact (POC) Confirm decision to use Option 1 Select the content format your system will use (Pipe Delimited, XML, HL7) Select the method your system will use to transfer information (Message, Upload)

TM 18 Option 1: Action Items (continued) Data Exchange Development by August 29 Develop any necessary code to create the selected file format and transport the file to CRA Send a test file for evaluation after development of code If using PHINMS Message to transfer the file, confirm that you have a digital certificate to send messages using PHINMS If using CRA Upload to transfer the data file, confirm that the user who will be uploading the file has a digital certificate, is assigned to the CRA Application, and has been loaded into the CRA Application with the PHA user role

TM 19 Option 1: Action Items (continued) Reporting Week and Clinic Confirmation by September 12 Confirm the 4 week period for which the Project Area will participate in the exercise Minimum of 4 consecutive weeks Average of 2 clinics per week with a minimum of 8 total clinics

TM 20 Cities Readiness Initiative (CRI) Heads up Funding for continuation of the Public Health Emergency Preparedness (PHEP) Cooperative Agreement Interim Progress Report guidelines Using information collected through a sample of seasonal influenza vaccination clinics, each grantee will report to CDC data on vaccination doses administered The group of participating seasonal influenza vaccination clinics must include at least one in each CRI metropolitan statistical area and at least one in each of an equal number of non-CRI venues. The latter may be urban, suburban, exurban, or rural and are to be selected in consultation with your DSNS program consultant A list of CRI/MSA by states will be provided

TM 21 Phase I: Pre-Exercise Planning Apr-Sep 2008 CDCTasksCDCTasks DAX 2008 Task Expectations Phase II: Exercise Oct-Dec 2008 Phase III: Post-Exercise Jan-Mar 2009  Webinars-Orientation & Introduction  Webinars-Option specific; DAX updates; open Q&A; option specific final exercise preparations  Selection of POC  Conf. Calls-Individual project areas; follow up for Q&A  PHIN conference  Identify & submit option choice  Development & Deployment- Version 1.8 release  DAX-Receive clinical data from 62 project areas  Finalize & submit reporting weeks & clinic location (CRI)  Review option guide  Develop feedback questionnaire  Respond to feedback questionnaire  Develop After Action Report  Conf. Call-After action review exercise feedback  Obtain digital certificates  Briefings and conf. presentations  Participate in After Action Review  Submit seasonal influenza vaccine doses administered data to CDC  Exercise support & trouble shoot PATasksPATasks

TM 22 Points of Contact and Resources Charles Williams, CRA Team, Division of Emergency Preparedness and Response or Submit POC information and option choice Obtain access to CRA Exchange CRA Help General aggregate reporting questions and inquiries PHIN Help Desk Issuing digital certificates Getting access to CRA demonstration site Problem solving To get a copy of this presentation:

TM 23 Upcoming Webinars and Meetings DateEventTopic June 24WebinarOption 2 and 3 Users July 9WebinarOption 1 Users and Exercise Status Report July 23WebinarOption 2 and 3 Users and Exercise Status Report August 6Conference CallGeneral Information and Questions August 21-22Doses Administered and Safety Training Conference Doses Administered Reporting Training and 2008 Exercise September 10WebinarExercise Overview and Refresher September 17WebinarRelease of CRA Version 1.8 October 1DAX 2008 Kickoff

TM 24 Questions?