Opportunities for Strengthening Public Health Surveillance Kathleen Gallagher D.Sc, MPH PH Surveillance & Informatics Program Office OSELS, CDC CSTE Pre-Conference Workshop, Pasadena CA June 9, 2013 Office of Surveillance, Epidemiology, and Laboratory Services Public Health Surveillance & Informatics Program Office
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Opportunities for Strengthening Public Health Surveillance Kathleen Gallagher D.Sc, MPH PH Surveillance & Informatics Program Office OSELS, CDC CSTE Pre-Conference.
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Opportunities for Strengthening Public Health Surveillance
Kathleen Gallagher D.Sc, MPH
PH Surveillance & Informatics Program Office OSELS, CDC
CSTE Pre-Conference Workshop, Pasadena CA June 9, 2013
Office of Surveillance, Epidemiology, and Laboratory Services
Public Health Surveillance & Informatics Program Office
Implement long-term oversight of NNDSS FACA, subcommittee
Organizational Support Upper level management must be engaged (OID,
CGH,OSELS, OD) Lines of responsibility within OSELS need to be
addressed Improve Project Management
All levels of staff should be knowledgeable about good project management practices
All stakeholders must be actively involved Primary responsibility for checking data quality should
reside with the CDC programs CDC FTE’s must actively oversee all contract work8
Recommendations for improvement (cont’d)
Revise system design and current data processing procedures Further collaborative review by stakeholders Retire NETSS format Conduct full evaluation of the NEDSS base system (NBS) Revise Common Data Store (CDS) to use technology
smarter Avoid creating dependencies on single standards,
domains or vendors
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Getting the Data Out to CDC Programs
Proposed Initial Design
Before Proposed
Ongoing Challenges
Organizational/operational barriers to success Staff capacity Hiring Budget MASO
Dependencies on contractors Expensive and may hamper our ability to get the most
innovative and cost-effective approaches
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Conclusions
Technical issues exist but current technologies and computational practices can solve these Simplifying the approach can improve performance
and reduce costs Organization challenges will be more
difficult to overcome Will require high level organizational support and
stamina Collaborative support needed may be hampered by our
“image problems” Need to build internal capacity to reduce reliance on
contractors
Action Steps Taken To Date
Staff who need project management training have been identified and training has been or is being scheduled
Contracts for IT services have been critically reviewed/ new contracts have been awarded
Continue development of simplified data processing and provisioning strategy
Reorganization should help to improve efficiency and focus
Internal high level discussions at CDC have occurred about governance and support.
FACA is scheduled to “ stood up” by end of 2013
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Ideal
• Strong local and state disease reporting systems that meet information needs– Shared and disease-specific – Local to state to national
• IT services enhance efficiency & minimize duplication– Platform(s) for multiple forms of surveillance– Consistent with emerging national information standards
• Healthcare and laboratory information systems• Information exchange• “Meaningful Use” program
• Exploit “cloud” computing environment– Support collaboration across jurisdictions and with CDC– Reduce data storage costs– Facilitate access to analysis tools
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Vision for the Public Health PlatformPHP Advisory Group
FedRAMP Cloud Service Provider (CSP)
Potential Authorized Users
Potential Public Users
Potential MobileApps Development
Users
Client
Mobile Client
Application
Encryption
ApplicationProgramming
Interface (API)
Data source
Message
Cancer Data
OtherData
CMS Data
Flat Files
XML Files
HL7 2.x
CDA
Other Formats
PublicData
PHIN MS
VPN Mirth
sFTP
Direct
Connect
ObjectIdentification
Validation
Authorization
Vocabulary
Rules
Authentication
Other
TRANSPORTSERVICES
STANDARDIZATION & NORMALIZATION
SERVICES
API
API
Other
Data QualityDash Board
WEAT Other
MySQL
LEGEND
STORAGE & DATABASING
SERVICES
DATA ACCESS
SERVICES
POTENTIAL DATAANALYSIS &
EXPLORATIONSERVICES
Public Access
Secure AccessElastic Data
StorageWeb Service
SecureTransmission
Input data(2-way)
Data flow(2-way)
NotifiableDisease
Data
SyndromicSurveillance
Data
Vital Statistics
Data
MessageGuides
6/10/2013
Immunization Data
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QUESTIONS?
Office of Surveillance, Epidemiology, and Laboratory Services
Public Health Surveillance & Informatics Program Office
NNDSS Message Guides Proposed Priority List
Priority Group 1
NETSS Core NBS Core Generic Case (v1,v2, HL7) Mumps Pertussis TB (v2, HL7) Varicella (v2, HL7) Hepatitis (HL7) STD (NETSS) Other NND’s ( to allow for retirement of all current NETSS feeds)
6/3/2013 18
National Public Health Surveillance and Biosurveillance Advisory Committee
Established to support CDC’s continued leadership in public health surveillance and biosurveillance.
Advises the Director of CDC regarding the broad range of issues impacting public health surveillance and the human health component of biosurveillance.
Chartered for 15 members.
National Public Health Surveillance and Biosurveillance Advisory Committee-
Timeline
November 6, 2012, MASO published through the federal register notice the request for nominations for candidate’s submission
Submission for nominees closed December 21, 2012.
January 2013, CDC Vetting Panel formed. February 2013, CDC Vetting Panel process
complete. Next Steps:
Finalize proposed slate of potential candidates Submit proposed slate to CDC’s MASO for final round of
vetting Submit slate to CDC Director and HHS Secretary for final