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Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Automated Influenza and Pneumonia Reporting.

Published byDinah Griffith Modified over 9 years ago

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Presentation on theme: "Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Automated Influenza and Pneumonia Reporting."— Presentation transcript:

1 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Automated Influenza and Pneumonia Reporting in an Electronic Death Registration System validated with Laboratory Confirmation Alvin T. Onaka, Ph.D. Hawaii Department of Health Office of Health Status Monitoring

2 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Influenza Deaths CDC Case Definition Influenza listed anywhere on the death certificate (Part I or Part II) Exclusions Haemophilus influenzae Parainfluenzae virus

3 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Pneumonia Deaths CDC Case Definition Pneumonia listed anywhere on the death certificate (Part I or Part II) Exclusions Aspiration pneumonia Pneumonitis Pneumococcal meningitis

4 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Case Definitions (continued) If both pneumonia and influenza are listed, count as influenza

5 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Weekly Mortality Reporting Previous Procedure Deaths due to Influenza or Pneumonia manually counted by DOH staff No timely means of lab confirmation from other DOH branch that electronically reports lab data (ELR)

6 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Previous Mortality Reporting Procedure Funeral Director gives death worksheet to certifier to complete Worksheet turned in to DOH and enters info. into system. DOH manually identifies Influenza & Pneumonia Weekly mortality report manually run from data system

7 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Weekly Mortality Reporting New Methodology New automated method of identifying Influenza or Pneumonia cases via the Hawaii Electronic Death Registration System (EDRS) New electronic laboratory confirmation between EDRS and ELR

8 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Current Weekly/Daily Mortality Reporting Procedure Certifier enters COD in EDRS Internet EDRS Later, Influenza/ Pneumonia lab results matched & results confirmed NEDSS At scheduled times, mortality reports automatically sent via email to Disease Outbreak Control Division & Vital Statistics Internet

9 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Automated Mortality Reports Adjustable interval for either hourly, daily or weekly automated reporting In addition to Pneumonia and Influenza case identification, custom reports are possible for future disease outbreaks (i.e. Syndromic Surveillance)

10 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Report Interval Adjustments

11 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 User Defined Custom Reports

12 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Automated Mortality Reports Every automated email notification includes: 1. Summary report in PDF format pattered after CDC’s weekly mortality report

13 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010

14 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Automated Mortality Reports (continued) Every automated email notification includes: 2. Excel spreadsheet showing Pneumonia and Influenza indicators, a unique case ID of decedent and the full literal COD text as entered by the certifier

15 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Excel Spreadsheet Influenza & Pneumonia Indicators Unique decedent ID Full literal text of COD by certifier

16 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Automated Mortality Reports (continued) Spreadsheet allows review of Influenza & Pneumonia status & pertinent certifier information for all deaths With full COD available, trained reviewers can ignore computer triggered flags and request record review of possible Influenza cases missed by computer Decedent privacy protected since DOH reviewers only see a Case ID

17 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Excel Spreadsheet–example 2 Full literal text of COD by certifier Influenza & Pneumonia Indicators Unique decedent ID

18 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Increasing Accuracy for Mortality Reporting and COD in general Incorporation of spell checker from NCHS’s SuperMICAR Spell checker reviews COD field and opens up a spell check box for certifier to accept or change possible misspelled word(s)

19 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Spell Checker for Certifiers

20 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 H1N1 Influenza Mortality Surveillance CDC Interim H1N1 Flu Surveillance Recommendation For vital statistics offices, CDC requests daily reporting

21 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 H1N1 Influenza Mortality Surveillance May 3, 2009 Daily Report

22 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010

23 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Lessons Learned from H1N1 Surveillance Medical Examiners and Coroners often certify record with “deferred – pending lab results”. The current automated reporting system will miss these Influenza cases

24 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Lessons Learned (continued) Drop to paper cases include backdated certification information Automated reporting system will also miss these cases

25 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 How Hawaii’s Influenza Cases are First Identified Physicians in hospital or clinic suspects respiratory disease and orders lab test + DOH-DOCD receives all lab results electronically with an Electronic Laboratory Reporting System (ELRS) DOH-DOCD identifies and investigates positive Influenza lab results

26 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 How Hawaii’s Influenza Cases are First Identified (continued) Certifier enters COD with key terms such as Influenza, H1N1, {other} in EDRS Internet EDRS DOH-Vital Stats staff enters COD for ‘Drop to Paper’ certification and identifies Influenza case before EDRS via manual email Internet DOH-DOCD staff receive automated EDRS email or for ‘Drop to Paper’ a direct email from Vital Stats staff

27 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Hawaii’s Confirmed H1N1 Influenza Death Cases 13 confirmed cases occurred in about a 1 year time period. About 24% cases first identified by the automatic email mortality reporting system About 38% cases first identified by Vital Statistics staff who entered in COD that was completed non-electronically About 38% cases first identified by Disease Outbreak Control Division (DOCD) staff from their Electronic Laboratory Reporting system (ELRS)

28 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Sample EDRS case history of an actual H1N1 Death Click Link

29 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 H1N1 laboratory confirmation case details in EDRS (freeform) View Notification From: To: HAWAIIAN ### MORTUARY Subject:NEDSS Status Changed (VSS) Creation date: 02/22/2010 09:00:20 Message: Case NEDSS Influenza Status has been changed to Influenza Test Confirmed as Positive while case has already been Sent to VSS. The new status was modified in NEDSS: No. Confirmation Status Comments: Influenz A/Swine- Positive

30 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010

31 Gateway to the Future: Improving the National Vital Statistics System St. Louis, MO June 6 th – June 10 th, 2010 Questions?

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