NHLBI Workshop

Data Needs for Cardiovascular Events, Management, and Outcomes

Public Health Information Network (PHIN) and National Electronic Disease Surveillance System (NEDSS) -
Dr. Claire Broome

What is PHIN (Public Health Information Network)?

• It is a multi-organizational business and technical architecture (www.cdc.gov/phin).
  • Technical standards
  • Data standards
  • Specifications to do work
• It is also a process.
  • Commitment to the use of standards
  • Commitment to participating in development and implementation of specifications

Moving from conceptual to real

• Many state and local health departments will have different stages of electronic systems and IT capacities
• Each state/jurisdiction will need to develop specific plans
  • Which systems to integrate
  • What funding streams available
• Central concept of PHIN is implementation of standards based interoperable systems so all
  • Maximize reuse of tools
  • Efficient use of technical expertise
  • Plan for extensibility

PHIN Components

• Applications
  • National Electronic Disease Surveillance System (NEDSS) – disease surveillance for 140 notifiable diseases, electronic laboratory reporting
  • BioSense – early event detection
  • Laboratory Response Network (LRN) – diagnostic capacity and information delivery

PHIN Tools available from CDC

• Software for industry standards based bi-directional inter-institutional messaging transport (PHIN MS)
  • ebXML “handshake,” PKI encryption and security
• Technical assistance & direct assistance available for public health partners (eg security IVV)
• PHIN Vocabulary Access and Distribution Services, including web accessible Standard Reference Tables
• Implementation Guides that specify data standards, message format

Surveillance Funding History

• 50 states, 6 cities funded for NEDSS: 43 started with Assessment & Planning phase in September 2000
• NEDSS ELC awards FY 2001-2005
• September 2002, 2003, 2004: Public Health and Social Services Emergency Fund provides >$1 billion for state and local public health preparedness capacity
  • Guidance from CDC and HRSA to use PHIN standards for IT investments
  • Guidance explicitly includes NEDSS as part of surveillance

How does NEDSS support public health surveillance functions?

• More timely detection via electronic laboratory results reporting from clinical diagnostic laboratory information system
  • For pre-defined results of public health importance, electronic message to health department automatically sent
  • Message includes structured data including test, result, provider ID, patient age, sex
  • Multi-jurisdiction labs, public health labs, some local labs

How does NEDSS support public health surveillance functions?

• Web data entry: case information available to local & state health departments immediately on entry (no paper, no mail)
• Support case investigation by state and local health dept
• Share lab results electronically between state public health lab & state surveillance
• Send standardized data electronically to CDC
• Same application for over 140 diseases, replace disease specific “stovepipe” applications
• Integrate with other PHIN components

NEDSS Base System:

• NEDSS compatible system for state and local use developed by an experienced web software developer (Computer Sciences Corporation)
• Also useful as a specific implementation of NEDSS -- e.g. standard messages, database model
• Version 1.0 includes 93 notifiable diseases, and modules for vaccine preventable diseases, hepatitis, bacterial meningitis and pneumonia
• Now at Version 1.1.3; includes over 140 notifiable diseases, expanded data entry capacity, reporting capacity, locally defined fields
• Added additional contractor, SAIC, to accelerate Program Area Module Development

Status of NEDSS surveillance enhancements April 2005