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2008 Vaccine Doses Administered Exercise (DAX)

Discussion of Options 2 & 3: Submitting Aggregate Reports using the Web-Based User Interfaces of the CDC’s CRA System

June 24, 2008

Presentation by:

Immunization Services DivisionNational Center for Immunization and

Respiratory Diseases and

Division of Emergency Preparedness and Response

National Center for Public Health Informatics

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Agenda• Learning Objectives• Background• DAX Summary• Data Entry and Reporting Workflow• Option 2 Details• Option 3 Details• Confirm Aggregate Report Details• CDC Resources and Contacts• Questions and Answers

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Learning Objectives

• Understand Options 2 & 3 for capturing aggregate counts in the CRA system

• Understand Project Area reporting of aggregate counts to CDC using the CRA system

• Understand the operational steps and decisions to be made for Options 2 & 3

• Understand the CDC technical support available for Options 2 & 3

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Background

• The National Strategy for Pandemic Influenza: Implementation Plan calls for monitoring of the appropriate use of a scarce pandemic influenza vaccine

• To accomplish this, states/project areas will track vaccine doses administered and collect and aggregate minimum data elements and transmit weekly to CDC

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DAX Summary

• The 2007 pilot demonstrated project areas’ ability to collect and report to CDC and CRA’s technical capability to accept and aggregate data

• The 2008 exercise expands on this capability to test the following:• Weekly reporting• Increased volume• Priority group tracking

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DAX Summary (continued)

DAX 2008 Data Set• Partner – from Project Area Valid Value List• Event – DAX2008• Start Date – Beginning date of the reporting

period• End Date – Ending date of the reporting period• Vaccine Type – from CVX codes for seasonal

influenza vaccine• Doses Administered – Aggregate count for

each General Population Priority Group

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DAX Summary (continued)

• Report data weekly for four consecutive weeks from eight or more clinics during the timeframe of Oct. 1 – Dec. 31, 2008; fully successful criteria:• Weekly reporting: aggregate reporting data

is sent by Tuesday for the previous reporting week (Sunday through Saturday; MMWR week); for any four consecutive weeks

• Increased volume: data is from a minimum of eight clinics over the course of the four weeks

• Priority group tracking: each general population priority group is tracked

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Options for Aggregate Reporting to CDC

• Option 1: For states and project areas collecting data via an existing immunization information system (IIS) or other application, technical specifications were developed for three different data exchange formats: flat file (pipe-delimited), XML file, HL7

• Option 2: For states and project areas collecting data manually, an aggregate reporting screen was added to CDC’s CRA application to allow direct data entry via a web browser

• Option 3: For states and project areas using CDC’s CRA application to collect patient level information, selected data elements will be automatically aggregated

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Data Entry and Aggregate Reporting

• Data Entry Specialist at clinic enters vaccine doses administered for the clinic

• Project Area POC reports the aggregate doses administered for the project area to CDC (by end of day – 11:59pm Tuesday following the week being reported)• Doses administered data for clinic and/or

person level is aggregated and displayed on screen

• Project Area POC with PHA rights confirms and reports the aggregate counts to CDC

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Option 2: Clinic Level Data Entry using CRA Web Form

Summary of Option 2 • Clinic staff collects summarized data for

doses administered • As clinics occur, the data entry staff enters

counts via CRA’s web-based aggregate reporting user interface

• Counts are entered at the clinic level by vaccine type; product and lot are optional

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Option 2: Clinic Level Data Entry using CRA Web Form (continued)

Process Considerations• Determine who will enter information on-

line

Technical Considerations• Staff entering data on-line must have

access to the internet via web browser• Staff accessing CRA must have a digital

certificate

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Option 2: Responsibilities

• Clinic Level• Enter aggregate data into CRA system for the clinic

if using at clinic level• Project Area Level

• Define and load clinics in CRA system• Identify data entry staff for each clinic in CRA

system• Oversee responsibilities; will be able to see and edit

entered data in CRA system• Confirm and report aggregate data (entered by

provider/local public health) to CDC• CDC

• Store and secure entered data• Create national reports

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Option 2: Aggregate ReportingScreen Shot

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Project Area Reporting

• CRA system will provide counts based on Project Area data entered

• Project Area POC confirms aggregate dose counts

• Confirmed counts are submitted to CDC

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Aggregate Count ConfirmationScreen Shot

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Option 3: Patient Level Data Entry using CRA

Summary of Option 3• Clinic staff collects patient level

information locally • Patient level data are entered into

CRA (at minimum core data elements)

• Clinic may choose to enter additional patient level information

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Option 3: Patient Level Data Entry using CRA

Process Considerations• Determine who will collect and enter

data and at what level of detail vaccination data will be collected

• CDC’s CRA system can collect detailed individual level information in addition to core data elements; additional elements are for Project Area use only

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Option 3: Patient Level Data Entry using CRA

Technical Considerations• Staff entering data on-line must

have access to the internet via web browser

• Staff accessing CRA must have a digital certificate

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Option 3: Responsibilities

• Clinic Level• Enter individual data into CRA system

• Project Area Level• Define and load clinics in CRA system• Identify data entry staff for each clinic in CRA

system• Oversee responsibilities; will be able to see and edit

entered data in CRA system• Confirm and report aggregate data (entered by

provider/local public health) to CDC• CDC

• Store and secure entered data• Create national reports

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Option 3: Patient Level Data Collection

Screen Shot

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Aggregate Count ConfirmationScreen Shot

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CDC Technical Support

• Get access to the CRA Demo system (http://crademo.cdc.gov) contact the PHIN Help Desk (PHINTech@cdc.gov)

• Apply for an SDN Digital Certificate at https://ca.cdc.gov; for password contact the PHIN Help Desk (PHINTech@cdc.gov)

• Contact the CRA Help at CRAHelp@cdc.gov to request access to the CRA Exchange area of CDC Team website (https://team.cdc.gov)

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Option 2 and 3: Action Items

• Identify a Point of Contact (POC)• Confirm decision to use Option 2 or

3• Confirm all individuals entering

data have digital certificates by August 29

• Option 2 - Identify the method and process for aggregation by August 29

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Option 2 and 3: Action Items (continued)

Reporting Week and Clinic Confirmation by September 12

• Confirm the 4 week period for which the Project Area will participate in the exercise• Minimum of 4 consecutive weeks• Average of 2 clinics per week with a

minimum of 8 total clinics

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Cities Readiness Initiative (CRI) Heads up

• Funding for continuation of the Public Health Emergency Preparedness (PHEP) Cooperative Agreement Interim Progress Report guidelines

• Using information collected through a sample of seasonal influenza vaccination clinics, each grantee will report to CDC data on vaccination doses administered

• The group of participating seasonal influenza vaccination clinics must include at least one in each CRI metropolitan statistical area and at least one in each of an equal number of non-CRI venues. The latter may be urban, suburban, exurban, or rural and are to be selected in consultation with your DSNS program consultant

• A list of CRI/MSA by states will be provided

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Phase I: Pre-Exercise Planning

Apr-Sep 2008

CDC

Tasks

DAX 2008 Task ExpectationsPhase II: Exercise

Oct-Dec 2008

Phase III: Post-Exercise

Jan-Mar 2009 Webinars-Orientation &

Introduction

Webinars-Option specific; DAX updates; open Q&A; option specific final exercise preparations

Selection of POC

Conf. Calls-Individual project areas; follow up for Q&A

PHIN conference

Identify & submit option choice

Development & Deployment-Version 1.8 release

DAX-Receive clinical data from 62 project areas

Finalize & submit reporting weeks & clinic location (CRI)

Review option guide

Develop feedback questionnaire

Respond to feedback questionnaire

Develop After Action Report

Conf. Call-After action review exercise feedback

Obtain digital certificates

Briefings and conf. presentations

Participate in After Action Review

Submit seasonal influenza vaccine doses administered data to CDC

Exercise support & trouble shoot

PA

Tasks

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Points of Contact and Resources• Charles Williams, CRA Team, Division of Emergency

Preparedness and Response cewilliams@cdc.gov or crahelp@cdc.gov • Submit POC information and option choice• Obtain access to CRA Exchange

• CRA Help E-mail CRAHelp@cdc.gov • General aggregate reporting questions and inquiries

• PHIN Help Desk E-mail PHINTech@cdc.gov • Issuing and renewing digital certificates• Getting access to CRA demonstration site• Problem solving

• To get a copy of this presentation: http://www.cdc.gov/phin/cra

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Upcoming Webinars and Meetings

Date Event Topic

July 9 Conference Call CRI Requirement and Open Q&A for Option 1

July 23 Conference Call CRI Requirement and Open Q&A for Options 2 and 3

August 6 Conference Call General Information and Questions

August 21-22

Doses Administered and Safety Training Conference

Doses Administered Reporting Training and 2008 Exercise

August 24-28

PHIN Conference Public Health Informatics: Collaboration at the Crossroads

September 10

Webinar Exercise Overview and Refresher

September 17

Webinar Release of CRA Version 1.8

October 1 DAX 2008 Kickoff

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Questions?