MDSS Training for Healthcare Providers in Michigan

1. MDSS TrainingFor Health Care Providers

2. The Michigan Disease Surveillance System Why we’re launching a new tool for public health surveillance in Michigan • Makes reporting of diseases/conditions easier, more efficient and closer to real-time so public health interventions can be implemented • Reduces delays in initiation of public health follow-up by correctly reporting to county of residence rather than county of diagnosis • Allows reporting 24 hours/day from your PC • Clarifies whether the case reported involves multiple providers/facilities • Provides documentation of facility’s role in reporting for regulatory and accreditation agencies • Allows instantaneous retrieval of summary reports of diseases • Reduces volume of necessary telephone communications for additional information between LHD and facility-based ICP

3. MDSS Healthcare Provider (HCP) Responsibilities • Confidentiality • The MDSS will contain confidential medical information on individuals reported into the system. Data is protected by system security and role defined access, but participants will continue to be bound by rules of confidentiality while accessing system information. MDSS is compliant with HIPAA regulations. • Participation • To realize the goals of this system, patient information must be entered in a timely manner. • HCP reporting responsibilities remain unchanged with this new, electronic method of reporting (Communicable Disease Rules R325.171 et al.). • Your enthusiastic support will make the MDSS a more productive and effective method of communicable disease surveillance

4. Accessing the MDSS • Software and System Requirements • Internet Access • Internet Browser (Internet Explorer 6.0 recommended) • Adobe Reader 5.1 or higher (www.adobe.com) • Single Sign-on (SSO) User ID and Password • Authorization to use the MDSS • Healthcare providers should partner with their local health department to register and utilize MDSS

5. MDSS Roles and Their Functions • Healthcare Providers (HCP) • Submit new cases • Search for, view, and edit data on cases submitted by that particular HCP • Run reports • Local Health Department (LHD) users • Local user administration • Submit new cases • Search for, view, and edit data on cases in their jurisdiction • Run reports • State Health Department users • Collaborate with local users • Submit new cases • Search for, view, and edit data on cases statewide • Run reports

6. How to access, navigate in, and exit the MDSS

7. Entering the MDSS • Point browser to https://sso.state.mi.us/ • Log In with SSO User ID and Password

8. The Top Navigation Bar The Top Navigation Bar consists of links to different modules: • Case Investigation: Contains all of the functions to enter and manage cases. You can add, change, and search the communicable disease information stored within MDSS. • Reports: Contains all of the reports available on MDSS. You can specify the type of report you wish to create and what information you would like to include on the report. • Logout: Terminates your session and returns you to the State of Michigan Department of Community Health Application Portal.

9. The Side Navigation Bar Case Investigation Reports The Side Navigation Bar displays links to available functions within the current module.

10. On Line Help • The User Guide is accessible on-line. It can be searched by the table of contents, by the index, or by keyword. • Click the HELP buttons throughout the application for assistance relative to your current screen. • Appendix C of the User Guide offers helpful data entry tips.

11. MDSS Security • Browser buttons (Back, Forward, Refresh, etc.) are not available for use in MDSS. • For security, MDSS and SSO will automatically log you out if your session remains inactive for more than 60 minutes. • Save your work frequently • Always save your work and log out of MDSS and the SSO portal if you leave your computer • You will lose unsaved work if you’re automatically logged out

12. Logging Out • Click Logout in MDSS, AND • Click Sign Off in the SSO Portal

13. Welcome to the MDSS

14. How to Enter a Case into the MDSS

15. New Case Entry • The New Case function allows new cases to be manually added to MDSS. • The New Case entry process is divided into three sections.

16. New Case Entry – Screen One

17. Screen One Key Field Definitions • Fields in Red with * are required fields. Case entry will not proceed unless they are completed (Unknown is generally an option). • Case Status – refers to the case definition criteria (Confirmed, Suspect, Not a Case, Probable, Unknown). • Patient Status - This field is used to indicate the present condition of the patient. • Patient Status Date - Automatically set to current date during case entry and updated when a change is made to the “Patient Status”. Can also be entered directly. • Refer to the section New Case in Chapter 4 of User Guide or view Online Help for more details.

18. New Case Entry – Screen Two

19. Screen Two Key Field Definitions • Age - Reflects the age at illness onset by subtracting Onset Date from Date of Birth (when available). Referral Date is used if no Onset Date is available. • Age Unit: Pertains to the measurement of the age of the patient at illness onset (in days, months, or years). • If Date of Birth is not available, Age and Age Units can be entered directly. Age units should be: • Days if Age is less than or equal to 30 days • Months if Age is less than 2 years • Years if Age is greater than or equal to 2 years

20. New Case Entry – Screen Three

21. Entering Lab Data for Referrals • Laboratory data is vital to most public health investigations. • There are two options for entering laboratory data during the New Case Entry process: • In the “Notes” section • Or the “Enter Lab Data” section

22. Entering Lab Data in the “Notes” Section During New Case Entry • Minimal lab information that should be entered • Laboratory Name • Test Name • Specimen Information (type and collection date) • Results (including result date)

23. Choosing “Enter Lab Data” During New Case Entry • You may choose to enter lab data through the “Enter Lab Data” option on the third screen of New Case Entry

24. Click Create New Lab Report • Add Lab Order information • Click Add New Lab • Add Lab Result information • Click Add Result

25. 6. Click Submit Changes 7. Click Save & Finish The case will then finish the last steps of the new case entry process behind the scenes . . .

26. Validation Clicking SAVE & FINISH or CONTINUE initiates a validation process. You must correct errors prior to proceeding.

27. Background Processing Once a case is entered, the following processes occur behind the scenes: • Geocoding: Validates address, assigns coordinates to map address, supports LHJ referral. • De-Duplication: The process of identifying and merging duplicate patients and case reports. This can result in the case not being immediately available to view. • CaseReferral: Determines the referral LHJ based on the Investigation Address (case address if available, otherwise provider or lab address), and assigns the case to the LHJ Administrator to initiate follow-up. More information about these processes can be found in the section Background Processing in Chapter 4 of the User Guide or by viewing Online Help.

28. Exercise - New Case Entries • Instructor Example • Student Exercise • Log in to the MDSS at https://sso.state.mi.us/ • Enter a New Laboratory Confirmed Case • Choose Salmonellosis as the Reportable Condition • Complete the three screens of new case entry including adding lab results in the case notes area • Enter New Case of Meningitis with suspected viral etiology • Choose “Meningitis-Aseptic” as the reportable condition • Add negative bacterial cultures, symptoms and CSF study results into the case notes area

29. Welcome Back to the MDSS

30. How to View and Edit a Case in the MDSS

31. Case Listings Overview

32. Case Listings - Sort Option • The Case Listings are displayed in order of Referral Date – the default sort order. • Select a different Sort Order and click SORT to change sort order (sorts are ascending order). • Investigator and Patient Name are sorted on last name. • See the section Cases in Chapter 4 of the User Guide or view Online Help for more details.

33. Case Listings - Search Option • The cases that appear on Case Listings screen are initially based on the default search criteria and your role and permissions. • When your User ID was created, the system automatically created some default searches for you. • When you change the Case Listings search option, the selected search becomes your default search for the duration of your session or until you select another search option.

34. Accessing the Case Details • Locate the specific case you want to access. • Click the EDIT button and the "Case Detail" screens will appear. Note: When you select a case, all cases associated with that patient will be un-editable.

35. Case Locking • When a case is selected for editing or viewing, all cases for the associated patient are locked by the user who first accesses the record. • All of the screens within “Case Details” will indicate that the case is locked and by which user.

36. Viewing a Locked Case • While the lock is in effect, other users will be able to view the case information but will not be able to edit any of the field values. • All of the fields are “grayed out” for the other user who is viewing this case. This indicates that all of the fields are disabled to the user until the case is unlocked. • This lock remains in effect until the user navigates away from the record.

37. The first tab contains the basic information about the case. From this screen, you can monitor the Investigation Status This is also where you can access the disease specific forms. The “Case Reporting” Tab

38. Case Investigation Status • Investigation Status – refers to the stage of the LHD investigation (New, Active, Completed, Cancelled, Superceded). This is the responsibility of LHD. • Resolved cases are marked “Confirmed” or “Not a Case” for Case Status and “Completed” or “Probable” for Investigation Status. • If duplicate cases are entered, all but one are marked “Superceded” for Investigation Status with one case investigated to resolution. • “Cancelled” is selected if the case cannot be investigated to resolution (e.g., patient or provider can not be reached).

39. Disease Specific Forms • Disease Specific Forms provide: • A place to record supplemental data for reportable conditions requiring more detailed information • A common format for handwritten and computer data entry • A substitute for mailing in case investigation forms • The Disease Specific Forms are based on the communicable disease forms used for case investigations • These forms can be saved, retrieved, and printed at any stage in the case investigation • All Web interface information entered, except Notes and Laboratory Reports, are automatically transferred to the Disease Specific Form when the form is Activated.

40. Disease Specific Form Access From the “Case Listings” screen: click EDIT next to appropriate case • Click the DETAIL button to open the Disease Specific Form • The Disease Specific Form opens in the MDSS window.

41. Disease Specific Forms Controls Activate Form Retrieves data and displays it in the form. Cancel Form Cancels changes without saving. You MUST start with Activate Form Case Definitions Opens Case Definitions in a New Window (Coming Soon) Submit Form Validates and Saves changes

42. Working With Disease Specific Forms • After opening form, always start by clicking the ACTIVATE button. This retrieves the form data from the database. • Add or edit data to form as required • Click the SUBMIT FORM button to save changes • Save changes frequently • Click the printer icon in the upper left corner to print partially or fully completed forms • Details are provided in the section Disease Specific Forms in Chapter 4 of the User Guide or by viewing Online Help.

43. Exercise – Disease Specific Forms • Instructor Example • Student Exercise • Create a new case (using a different name and demographic information) with “Meningococcal Disease” as the reportable condition • Find the new case in your case listings, open the Disease Specific Form and click ACTIVATE • Add laboratory, epidemiologic and other information including the following data: • Bacterial species Neisseria meningitidis of serogroup W135. • Symptoms: confusion/memory loss and stiff neck/back • Muscle paralysis in the “neck” muscles • Fever of 101 degrees Fahrenheit • Save the new information by clicking SUBMIT FORM

44. Welcome Back to the MDSS

45. Editing Address Information • Address information can be edited in the “Address History” tab • Refer to the section Cases in Chapter 4 of the User Guide or view Online Help for more details.

46. Change of Jurisdiction Warning The Change in Jurisdiction Warning occurs if you change the Onset Date, Investigation Address, or Home Address “From and To Dates” because the Address dates and Onset Date determine LHJ referral.

47. The “Lab Reports” Tab • The Lab Reports tab is where you can view electronic lab reports (ELRs). • “Electronic” value of “Yes” means it was received by automated referral. • Electronic lab reports cannot be modified. • Click CREATE NEW LAB REPORT button to manually add a lab report. • Click EDIT to view or edit an existing lab report. • Use DELETE only if an entered report is not supposed to be associated with the patient. • The Lab Reports tab lists all labs associated with a patient and not just the particular case you are viewing.

48. Other Case Detail Tabs • Demographics - provides information regarding the patient and collects important demographic information. • Referrer - provides information regarding the case reporting and who made the referral. Referrer information has two major sections: • Person Providing Referral • Primary Physician • Notes - provides a free form entry of text notes that are associated with a case investigation. • Refer to the section Cases in Chapter 4 of User Guide or view Online Help for more details about these sections.

49. How to Search in the MDSS

50. New Searches The New Search function allows you to create a new search.