June 24, 2008

1. 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 Division National Center for Immunization and Respiratory Diseases and Division of Emergency Preparedness and Response National Center for Public Health Informatics

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. Option 2: Aggregate ReportingScreen Shot

14. 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

15. Aggregate Count ConfirmationScreen Shot

16. 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

17. 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

18. 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

19. 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

20. Option 3: Patient Level Data CollectionScreen Shot

21. Aggregate Count ConfirmationScreen Shot

22. 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)

23. 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

24. 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

25. 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

26. DAX 2008 Task Expectations PA Tasks CDC Tasks Phase I: Pre-Exercise Planning Apr-Sep 2008 Phase II: Exercise Oct-Dec 2008 Phase III: Post-Exercise Jan-Mar 2009 • Webinars-Orientation & Introduction • Conf. Call-After action review exercise feedback • DAX-Receive clinical data from 62 project areas • Webinars-Option specific; DAX updates; open Q&A; option specific final exercise preparations • Develop After Action Report • Exercise support & trouble shoot • Conf. Calls-Individual project areas; follow up for Q&A • Briefings and conf. presentations • Develop feedback questionnaire • PHIN conference • Development & Deployment-Version 1.8 release • Selection of POC • Submit seasonal influenza vaccine doses administered data to CDC • Respond to feedback questionnaire • Identify & submit option choice • Finalize & submit reporting weeks & clinic location (CRI) • Participate in After Action Review • Review option guide • Obtain digital certificates

27. Points of Contact and Resources • Charles Williams, CRA Team, Division of Emergency Preparedness and Responsecewilliams@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

28. Upcoming Webinars and Meetings

29. Questions?