1. Lessons Learned  The Internet is a useful tool for building program capacity  Modern TB control requires –Coordination –Collaboration across jurisdictions  Regional efforts offer benefits to state programs and to CDC Genotyping Database  Work group defined data management capacity and needs  Planning for a web-based regional data set  Collaborated around CT cluster NewEnglandTB.com  Developed a team with expertise  Built a website to –Increase cohesiveness and visibility –Promote regional and state education –Exchange tools and materials Interactive Web Presentation April 11, 2006 8:00 A.M. Accreditation: CME, CNE, CHES. This activity has been designated by CDC for 1 Category 1 hour toward the AMA physician's recognition award, 1.2 hours toward the ANCCCA nurse’s recognition award and 1 hour accreditation by NCHEC for educators.  TThe New England TB control programs invite you to participate in a case presentations of a patient with tuberculous meningitis and HIV infection. Eliminating TB Case by Case A Case Series for Providers and Clinicians Joseph Gadbaw, Jr., MD Lawrence and Memorial Hospital New London, CT Access the TB Case Series at : www.mymeetings.com/nc/join.php?i=PG1678747&p=2006&t=c Toll free audio access: 888-552-9191 Password = 2006 # Eliminating TB Case by Case  Providers present their cases  Designed to reach private providers  Created basis for distance learning –web-based –continuing education credit  Held 3 successful presentations  Need to market case series TB Education Objective “Support and assist the Northeast RTMCC for the purpose of planning and promoting region- wide training and education of staff, providers, and patients using in-person or distance modalities.” The Internet as a Regional Tool The Internet is a tool we have used for building program capacity.  Educational series “TB Case Series for Providers and Clinicians”  NewEnglandTB.com website To share materials and experiences  Genotyping database Resources  State –TB programs/health departments –Schools of Public Health  Regional –TB Advisory Committees –RTMCC  CDC –DTBE –PHPS, Informatics New England Regional Plan The regional plan revolves around 5 strategies  Communication  Education  Universal genotyping  Program evaluation  Consultation One size does not fit all  Maine, NH, and VT do not have outreach staff  Connecticut and Mass. are organized into health districts Type of Provider (%), 2004 Percent Foreign-born TB by State and Year New England TB, 2004  TB cases –486 cases –3.4 / 100,000 (range 1.2-4.3)  Cases increased in 3 states –MA (9%) –RI (10%) –NH (59%) What can regionalization do for TB control?  Expand expertise  Build on the diversity of experiences and practices  Involve stakeholders  Increase ability to affect health  Strengthen advocacy Why Regionalization?  The purpose of TB regionalization is to mobilize and coordinate broad collaborative actions  The approach uses existing infrastructure A New Model of TB Control “The traditional model of TB control … is no longer the optimal approach.” CDC. “Controlling Tuberculosis in the United States,” 2005 Background In 2005, the 6 New England TB programs started collaboration on a new approach to TB elimination by  Building program capacity on a regional level and  Identifying strategies for collective problem solving New Concepts in TB Control Internet-Based Strategies for Reaching Providers The New England Experience Mark Lobato, * Kathy Hursen, † Erin Howe, ‡ Lisa Roy, ¶ Judy Proctor, ¶ Helen McCarthy, § Subroto Banerji, * * CDC-DTBE, † Massachusetts Division of TB Prevention and Control, ‡ Northeast RTMCC, ¶ New Hampshire TB Program, § Rhode Island Office of Communicable Diseases 0 10 20 30 40 50 60 70 80 90 CTMEMANHRIVT 2002 2003 2004 % State 0 10 20 30 40 50 60 70 80 90 HDPrivateBoth CT MA ME NH RI VT