1.NNDSS Modernization Initiative (NMI): NNDSS-Related Highlights from 2019 CSTE Annual Conference
Division of Health Informatics and Surveillance
July 16, 2019
2.Agenda
Welcome and Announcements
2019 CSTE Annual Conference and NNDSS-Related Sessions
Questions and Answers
2
3.Lesliann Helmus, MSPH, CHTS-CP
Associate Director for Surveillance
Michele Hoover, MS
Lead, State Implementation and Technical Assistance
NMI Announcements
4.NMI eSHARE Webinar
Highlights from the 2019 CSTE Annual Conference
Tuesday, July 16, 2019
3:00-4:00 pm ET
Kate Goodin, MPH, MS
Meredith Lichtenstein Cone, MPH
Shaily Krishan, MPH
Barbara Gabella, MSPH
Richard Danila, Ph.D., MPH
Molly Crockett, MPH
Sherri Davidson, Ph.D., MPH
5.Agenda
Overview of 2019 CSTE Annual Conference & Overview of NNDSS-related sessions- Shaily Krishan (CSTE)
Review of approved 2019 CSTE Position Statements
Infectious Disease Position Statements- Richard Danila (MN)
Non-infectious Disease Position Statements- Barbara Gabella (CO)
Recap of S/I conference workshop- Kate Goodin (AZ)
CSTE Workgroups and projects- Molly Crockett (MA), Sherri Davidson (AL)
Surveillance/ Informatics Steering Committee Roundtable summary- Kate Goodin
2019-2020 Surveillance/ Informatics priorities- Kate Goodin
Q & A
6.Overview of 2019 CSTE Annual ConferenceShaily Krishan
7.
8.Conference Sessions
Mon-Wed, June 3-5
8 tracks
712 total presentations
225 Breakout
228 Quick
59 Lightning
132 Posters
68 Roundtables
3 Sponsor Roundtables
Attendance
1,607 registered attendees
State Health Agency: 48%
Local Health Agency: 16%
Federal Agency: 15%
Student: 2%
Conference Workshops
Sunday, June 2
14 workshops
Beginning in 2019, the State Epi Forum will be recurring every year
1,083 attendees
t
9.CSTE Annual Business Meeting
Thursday, June 6
Review of Voting Rights and Council Audit
State of CSTE Address – Sarah Park
Presentation of 2019 Position Statements
New Business and Installation of New President, Sharon Watkins
10.CSTE Executive Board
2019-2020
President: Sharon Watkins, PA
Vice President: Sarah Park, HI
President-Elect: Sherri L. Davidson, AL
Secretary-Treasurer: Marcelle Layton, NYC
Infectious Disease: Richard Danila, MN
Chronic Disease/MCH/Oral Health: Angela Dunn, UT
Environmental/Occupational/Injury: Melissa Jordan, FL
Surveillance/Informatics: Kate Goodin, AZ (Maricopa County)
Cross Cutting I: Barbara Gabella, CO
Cross Cutting II: Kenneth Komatsu, AZ
Officers
Steering Committee
Chairs
11.NNDSS Related Roundtable Sessions
Defining the Future for NNDSS (June 3)
Leveraging the NNDSS infrastructure for exchange of other types of case-based surveillance data
New strategies for data presentation and access
Methods to make the data more timely and relevant, providing feedback on data quality, maintaining the integrity of the initial data transmitted
Increasing CDC’s capacity to onboard states to send HL7-based messages
Implementation of ‘Country of Usual Residence’ in the 2019 Tables of National Notifiable Infectious Diseases and Conditions (June 3)
Provided background for why 2019 NNDSS tables of infectious diseases and conditions are stratified by “Country of Usual Residence” (COUR)
Suggestion to identify a state author to update position statement 11-SI-04 to include updated guidance about the Country of Usual Residence data element (which replaced the foreign resident data element)
12.NNDSS Related Roundtable Sessions (continued)
NNDSS Low Incidence and International Quarantinable Disease Verification Protocol: Suggestions for Changes and Enhancements (June 4)
Describe the process for CDC to verify low incidence conditions based on the 03-ID-11 PS; proposed enhancement to the CDC MVPS to make the verification process more transparent or update 03-ID-11 PS about low incidence verification
Recommendation to discuss low incidence verification processes within NNC Criteria Workgroup (Surveillance Policy Subcommittee)
Informatics and CDC Emergency Response: Options for Standardizing Emergency Case Notification Messaging to CDC (June 5)
Presented strategies to utilize current NNDSS infrastructure for jurisdictions to submit standardized emergency case data for domestic events, special studies or evolving diseases
Presented options to use Generic v2 as a base for emergency response variables, or a stand-alone MMG containing data elements for emergency response
13.For more information..
2019 Annual Conference Presentation Recordings:
CSTE Confex Website: https://cste.confex.com/cste/2019/meetingapp.cgi
2019 Position Statements – Coming Soon!
Position Statement Archive: https://www.cste.org/page/PositionStatements?
14.Review of approved 2019 CSTE Position Statements: Richard Danila, Barbara Gabella
15.Approved 2019 CSTE Position Statements: Infectious Disease
19-ID-01: Public Health Reporting and National Notification of Plague
19-ID-02: Standardized Surveillance Case Definition for Blastomycosis
19-ID-03: Case Definition for Non-pestis Yersiniosis
19-ID-04: Revision to the Case Definition for National Legionellosis Surveillance
16.Approved 2019 CSTE Position Statements: Infectious Disease (continued)
19-ID-05: Revision to the Standardized Case Definition, Case Classification, and Public Health Reporting for Acute Flaccid Myelitis
19-ID-06: Revision of the Case Definition for Hepatitis C
19-ID-07: Changes to Public Health Reporting and National Notification for Spotted Fever Rickettsiosis (including Rocky Mountain Spotted Fever)
19-ID-08: Revision to the Case Definition for National Pertussis Surveillance
17.Approved 2019 CSTE Position Statements: Non-infectious Disease
19-MCH-01 – “Neonatal Abstinence Syndrome Standardized Case
Definition”
Creates two tiers: (1) Providers and laboratories report to public health legal authorities, and (2) Public health staff analyze ICD-10-CM coded data from providers and facilities.
Does NOT recommend adding to Nationally Notifiable Conditions List.
19-CC-01 – “Nonfatal Opioid Overdose Standardized Surveillance Case
Definition”
Creates standardized definition, which will encourage comparable estimates across jurisdictions, building upon CDC work.
Does NOT recommend adding to Nationally Notifiable Conditions List.
18.Recap of S/I Conference Workshop:“Surveillance: Getting from Data to Action”Kate Goodin
19.Workshop Themes
Data Acquisition
Data Sharing and Release
Data Marketing
Workforce
20.CSTE Workgroups and ProjectsMolly Crockett, Sherri Davidson
21.Data Standardization Workgroup
Co-chairs: Molly Crockett (MA): Molly.Crockett@state.ma.us, Laura Erhart (AZ): laura.erhart@azdhs.gov
Workgroup charge:
To convene epidemiologists and informaticians to develop consensus on common definitions for core surveillance data elements to address jurisdictional variation
Workgroup mission:
Improve data quality through the development and application of consensus definitions for the core data elements for general communicable disease surveillance
22.Data Standardization Workgroup
Outputs:
Consensus reports pertaining to surveillance processes, definitions of data elements or other practices under consideration
Developed CSTE Issue Brief titled “Data Standardization: Dates of Importance to Public Health Surveillance”
Data elements in Generic v2.0 and Generic v2.0-based message mapping guides (MMGs) included in brief: Illness (Symptom) Onset Date, Report Dates, Laboratory-Related Dates, (Clinical) Diagnosis Date
Where applicable, recommend integration into future updates to GenV2 or as part of GenV3
Aimed at standardizing data elements sent to CDC or used nationally
Develop a standardized, repeatable process for reaching a consensus definition
Meeting schedule: Monthly, fourth Friday 1-2 ET, next meeting is July 26
CSTE staff contact: Shaily Krishan (skrishan@cste.org)
23.NMI Evaluation Workgroup
Workgroup charge:
To convene epidemiologists, informaticians, and surveillance experts from state, local and territorial jurisdictions participating in NMI Message Mapping Guide (MMG) implementation activities, and other key stakeholders to evaluate and identify improvements in processes related to MMG implementation, MMG onboarding, MMG maintenance, and Technical Assistance (TA)
Convened in April 2019, meets monthly
Next call: July 23, 3-4 ET
CSTE staff contact: Shaily Krishan (skrishan@cste.org)
24.NMI Evaluation Workgroup Activities
Conduct structured workgroup discussions to develop the NMI Evaluation Assessment to address:
Barriers encountered by jurisdictions in the MMG implementation and/ or onboarding process
Usefulness of NMI technical assistance (TA)
Sustainability of jurisdiction's investments in overall MMG implementation, onboarding and maintenance activities
Satisfaction of jurisdictions with the overall experience of MMG implementation, onboarding, and technical assistance
Satisfaction of jurisdictions with CDC's efforts to standardize and harmonize MMGs, and to involve jurisdictions in the development and piloting of MMGs
Conducted MMG Implementation Listening Session with CSELS, CDC programs and states to discuss challenges that jurisdictions encounter during MMG implementation, and identify methods for CDC to make process improvements
25.NNC Criteria Workgroup
First meeting was held on July 16, future meeting schedule coming soon!
Contact Alexis Darden to join workgroup (adarden@cste.org)
Consider why conditions are nationally notifiable
Document criteria for adding/retaining
Produce a Policy Brief
Once we establish NNC criteria, review all current NNCs through that lens
Draft PS to remove all NNCs not meeting retention criteria
Consider recommending sections to PS template that authors will complete in the NNC section that explicitly lists how/why it meets the criteria, and perhaps adding a term limit for NNCs to expire, or be renewed
26.Community requests clarification on how SyS data submitted to CDC is being used
Findings released at regional or national level?
Future plans for data use?
What level of re-release is part of the base cooperative (funding) agreement?
Potential action items:
Increased collaboration between states and CDC
Determine a way for communication between affected states and CDC prior to publication of data
Position statement on data release policies for SyS
SyS POC list
Summary of Syndromic Surveillance Roundtable
28.Feedback
Are there critical surveillance and informatics areas not represented by the current committee structure?
Non-infectious diseases
Legal, governance, privacy
Workforce
Cross-program solutions
What do you see as the most critical issue facing you in the next year?
Staffing
MMG timelines
How could CSTE and this committee support you?
“Advocacy” with CDC
Public health lab communication and connection
Core functions:
Defining informatics
Standardization
Visioning
Cross sector collaboration
Training
How do you prefer to be engaged?
Emails (9)
Conference calls (10)
Peer-to-peer mentorship (8)
Polls/surveys (1)
29.2019-2020 S/I PrioritiesKate Goodin
30.Planning for the future
Strategic planning
Internal forces:
Funded projects
Organizational capacity
External forces:
Funding
Other organizations
Needs of STLT HD informatics staff
31.Questions?
Questions on Position Statements?
Email Meredith Lichtenstein Cone (mlichtenstein@cste.org)
Questions on the Data Standardization Workgroup or NMI Evaluation Workgroup?
Email Shaily Krishan (skrishan@cste.org)
Questions on the NNC Criteria Workgroup?
Email Alexis Darden (adarden@cste.org)
32.
33.
Access the NMI Technical Assistance and Training Resource Center at
https://www.cdc.gov/nmi/ta-trc/index.html
Request NMI technical assistance or onboarding at
edx@cdc.gov
Next NMI eSHARE is August 20, 2019 – details at
https://www.cdc.gov/nmi/eshare.html
Subscribe to monthly NMI Notes news updates at https://www.cdc.gov/nmi/news.html
34.CSTE National Office Contact Information
CSTE National Office
2635 Century Parkway NE, Suite 700
Atlanta, Georgia 30345
770.458.3811
770.458.8516
skrishan@cste.org