1. Turning STD Surveillance Data into Action: OASIS Outcome Assessment through Systems of Integrated Surveillance

2. OASIS (Outcome Assessment through Systems of Integrated Surveillance)  NCHSTP–funded demonstration project initiated in 1998  Purpose at that time was to improve state and local surveillance capacity Integrated interpretation and use of data (STD, HIV, TB, reproductive health) Data quality improvement Data analysis & dissemination Matching datasets Geocoding & mapping Enhanced behavioral surveillance Interdepartmental collaboration Community linkages

3. New York City Baltimore San Francisco OASIS Project Sites: past and present Currently active sites Past sites Texas Missouri California Oregon Washington Michigan Indiana Ohio New York State Massachusetts Virginia North Carolina Florida Colorado

4. Examples of activities in which OASIS has been involved over the years

5. Using Geographic Information Systems (GIS) to Enhance Surveillance  Geocoding  Address correction  Morbidity assignment  Mapping  Routine Surveillance Trend analysis  Case visualization Rapid response & outbreaks Education & advocacy  Spatial analysis / research applications

7. GIS Capacity Survey - 2005  Survey of 65 project areas 85% response rate  46% of project areas do not use GIS Lack of time Lack of skill Not sure why useful  Of those that do, most use ArcView Opportunities for licensing agreements, STD-specific training  Broad range of how confidentiality addressed Need for confidentiality guidelines

8. Matching Data Sets  Matching is an inexpensive, efficient way to augment knowledge Co-infection Missing information Case finding Re-infection  Can be made easy/simple Automated matches Data warehouses NEDSS-like systems  Can improve collaboration with other programs  Can provide actionable results Interpret carefully Even negative match can provide info

9. Other Sources of Data  Registries (ex: birth, death,HIV/AIDS)  Hospital databases  Laboratory databases  Service utilization records  Surveys (ex: BRFSS, PRAMS)  Incarceration records  Substance abuse treatment program records  Commercial data (ex: pharmaceutical sales)  Census data

10. Washington State - HIV Prevalence Among Infectious* Syphilis Cases, 1994 - 2002 *Primary, secondary and early latent syphilis          199419951996199719981999200020012002 Year 0 20 40 60 80 100 Number of Cases 0 10 20 30 40 50 60 Percent HIV+ All Infectious Syphilis Cases Percent HIV+ 

11. California Unilab and FPACT Claims Data : Female Chlamydia Positivity By Age and Race/ Ethnicity Dec00-Jul01

12. Enhanced Gonorrhea Surveillance 2003 - 2005  Developed common set of data elements  Piloted wide variety of methodologies STD clinic vs. population-based sampling Patient vs. provider interview In-person vs. telephone

13. STD Surveillance Network (SSuN)  SSuN is an ongoing sentinel surveillance system  SSuN was developed out of OASIS  Purpose: to improve national capacity to detect, monitor, and respond to emerging trends in STDs and related behaviors

14. Other activities, not direct products of OASIS, but “In the spirit of OASIS….”  Data quality improvement Improvement of reporting timeliness Development of inter-program data use policies  Data analysis & dissemination Hardware/software/training Web-based access to surveillance & program data  Community linkages On-line community-based provider resource directory Statewide Gonorrhea Advisory Panel

15. OASIS – Present  It has evolved into an unfunded STD surveillance workgroup  Purpose: to identify ways to improve collection, analysis, dissemination, and utilization of STD surveillance data  It is a joint effort by CDC, state, and local health departments STD/HIV collaborative development of data confidentiality guidelines Identification of synergies for HIV/STD surveillance Development of national STD surveillance capacity survey Implementation of GIS survey recommendations Dissemination of lessons learned

16. OASIS – Current activities  Carried out a survey of level of STD/HIV/TB program integration at project sites  Will conduct a data confidentiality workshop at the 2008 National STD Prevention Conference  Exploring new collaborations with NCSD  Preparing a multi-manuscript publication of highlights of OASIS accomplishments

17. Summary OASIS is an STD surveillance workgroup that works to identify and discuss key surveillance issues Its identity has been re-defined over the years, but its commitment to improve surveillance remains