1. The New Jersey Communicable Disease Reporting and Surveillance System (CDRSS) Recipient of the 2008 Nicholas E. Davies Award of Excellence for Public Health

2. The State Population: 8.7 million (2006 U.S. Census) 21 counties 566 municipalities 114 local health departments 74 acute care facilities

3. The Stakeholders Over 1200 users representing the following New Jersey Department of Health and Senior Services (NJDHSS) – nurses, epidemiologists clerks and lab staff Local Health Departments (LHDs) – health officers, nurses, epidemiologists and clerks Hospital – Infection control professionals (ICPs), lab staff Commercial labs All these entities are required to collaborate and report as per the New Jersey Administrative Code

4. CDRSS Highlights Patient-centric, web-enabled, PHIN-compliant Integrated electronic laboratory reporting (ELR) Extensive fields for case and outbreak management Integrated analysis, visualization and reporting tools Modules for reporting aggregate data for: Influenza-like illness Antimicrobial resistance Built-in administrative flexibility to add and manage diseases, dropdown values, reporting criteria, etc.

5. Case Management Fully integrated workflow processes Access to cases based on jurisdiction and/or role in public health response Use of GIS to assign jurisdiction Different tabs to reflect progress of follow up

6. Complicated Geography Example

10. MunicipalityCountyHealth Department Franklin Twp Somerset Franklin Twp HD Montgomery TwpMontgomery HD South Brunswick Middlesex South Brunswick HD Plainsboro TwpMiddlesex County HD Lawrence Twp Mercer Lawrence Twp HD West Windsor TwpWest Windsor HD Princeton Boro Princeton Regional Health Commission Princeton Twp Hopewell TwpHopewell HD Same city name and ZIPcode – Eight different Health Departments!

11. Electronic Laboratory Reporting (ELR) Fully integrated ELR Standardized information adhering to CDC and national standards Administrative flexibility to assign LOINC/SNOMED codes for processing new lab results Error reports to track problems and streamline reporting

12. Extensive Analysis, Visualization and Reporting Tools Tables and lists – over 175 reports Disease / case management Resource management Grants / funding / presentations Data analysis / research Maps Charts / graphs / dashboards

13. Outbreak Management Setting up signs symptoms and risk factors for outbreaks Assigning case classification for outbreaks Mapping outbreaks Special reports for outbreaks

14. Modules for Aggregate Information ILI module for monitoring influenza activity receive reports from schools, long-term care facilities and nursing homes flexibility to change reporting time frames flexibility to report by individual entity or jurisdictional agencies AR module for monitoring antimicrobial resistance includes administrative flexibility for CDS to assign pathogen-antibiotic relationships for monitoring set up time frames for reporting assign sites for reporting

15. Impact on Public Health The New Jersey Communicable Disease Reporting and Surveillance System (CDRSS)

16. 1. Improved timeliness and response of notifiable disease reporting and follow up Internal analysis determined that users entered cases average of 3 to 4 days after illness onset in 2004, compared to 28 days in 2003 In 2004, NJ identified a multistate outbreak of Salmonella berta Internal analysis shows timely prophylaxis of HAV contacts increased from 33% in 2005 to 99% in 2007

17. 2. Minimized underreporting Note: 2006 decline attributed to decrease in Lyme disease reporting

18. 3. Improved data quality by enhancing communication and report completeness Streamlined communications for meningococcal disease follow up in daycare attendee Enhanced hepatitis B monitoring for perinatal follow up

19. 4. Empowering the users http://www.state.nj.us/health/cd/documents/newsletter0109.pdf

20. Under Current Development Additional ELR from Quest Labs – Horsham, PHEL STD Module – likely to be completed by Jan 1, 2011 Updated contact tracing functionality

21. Future Plans ……. If additional becomes funding available! Implementing NEDSS messaging with CDC Implementing public health case reporting with NJ HIEs Bi-directional case reporting with NJ HIEs

22. Contact Information Simi.Octania-Pole@doh.state.nj.us Phone: (609) 292 1918