Disease Reporting

1. Disease Reporting • Nationally Notifiable Diseases • Council of State and Territorial Epidemiologists meet annually to discuss the notifiable diseases and determine case definitions. • State: Reportable Diseases and Conditions • Each state determines what diseases and conditions are reportable • States report morbidity data to CDC, which is published weekly in the MMWR.

2. Disease Reporting • Missouri: Code of State Regulations Title 19, Division 20, Chapter 20 • 19 CSR 20-20.020: Reporting • What is reportable • When it has to be reported • Who has to report • How it is to be reported • 19 CSR 20-20.080: Duties of Laboratories • Report conditions noted in 19 CSR 20-20.020 • Require certain isolates and specimens be submitted to the State Public Health Laboratory (ex. Salmonella)

3. Disease Reporting • Entry Requirements: LPHA’s are required to report disease/conditions to the Department of Health within 24 hrs. Entry into WebSurv constitutes reporting. • DHSS program areas currently using WebSurv • Communicable Disease • Tuberculosis • Hepatitis B & C

4. Data Quality • Data collected and entered into WebSurv is the primary source of communicable disease data in Missouri. • The importance of the data cannot be overstated! • Surveillance, Reports, Policy development • Tool used to achieve our goal of protecting the public’s health • The data you enter may be the key in identifying an outbreak or preventing one! • Data quality (accuracy and completeness) is up to you! Please remember: Garbage In… Garbage Out!

5. Terminology • Party: Any person or organization that has some association or involvement in the condition and must be registered in the database before being associated with a condition. These parties are persons, reporters, physicians, hospitals, laboratories, etc. • Party Identification Number: Unique, system-generated number assigned to the party at entry. Can be used to search for and retrieve the party in WebSurv. • Condition Identification Number: Unique, system-generated number assigned to the condition at entry. Can be used to search for and retrieve the case in WebSurv.

6. Terminology • Case Definition: A set of criteria that are used to consistently determine who are considered cases • Communicable Disease Investigation Reference Manual (CDIRM) • CDC http://www.cdc.gov/ncphi/disss/nndss/casedef/case_definitions.htm • Condition Status: The classification of the case based on the case definition (i.e., confirmed, probable, suspect, or presumptive) • CD1 Report Form: Disease case report form. Often the form used by medical providers and other reporters to report conditions. • Supplemental Form: Report form used to investigate specific cases (e.x. Enteric Supplemental Form)

7. Terminology • Jurisdiction: • Local Public Health Agency that is responsible for the investigation and follow up. • Jurisdiction is determined by the address associated to the condition, generally the address of the party. • If the case’s (party’s) address is not known then the system defaults to the jurisdiction of the medical provider or laboratory. Note: Communication is important between organizations to ensure the case is assigned to the appropriate jurisdiction and investigated in a timely manner.

8. Application • Overview • Advantages of .Net • Settings • Warnings • Turning Off Pop Up Blockers • Login to WebSurv • Screen Layout • Saving Information • Tips • Validations • Grid Sorting and Navigation • Online Instructions • Entering Notes in WebSurv • Disease Specific Guidance • View/Read Only Condition Screens • WebSurv Don’ts • Progress Indicator Warnings

10. Overview • WebSurv is a component of MOHSAIC and works as the department’s application for entering, storing and retrieving reports of communicable disease. • WebSurv is a .Net application, which means it is web-based. • Application is stored on a secure server.

11. Advantages of .Net • Users only need a web browser with internet capability to use the application. • Users do not need to download application to their computer. • Changes made to application by ITSD are available to users as soon as it is implemented.

12. Settings • Recommended screen resolution: 1024 x 768 • Recommended browser: Internet Explorer (version 7 or greater) • WebSurv internet URL is: https://webapp03.dhss.mo.gov/webmohsis

13. Warnings • Turn off Pop Up Blocker which interferes with the application or allow pop ups from dhss.mo.gov. • Remove Add On Internet Explorer tool bars such as those from Google and Yahoo. • Delete cookies and temporary files in browser if you experience problems.

14. Turning off Pop Up Blocker • Open Internet Explorer • Go to Tools • Pop-up Blockers • Click turn off Pop-up Blocker

15. Delete Cookies & Temporary Files • Open Internet Explorer • Go to Tools • Select Delete Browsing History… • Click on the Delete all… button • Check the box next to Also delete files and settings stored by add-ons. • Then click on Yes

16. Getting Access To gain access to WebSurv, users must complete an A.S.A.P request. A link to the A.S.A.P website can be found on the homepage of the Intranet. Once there you can select the following from the dropdown menus: Area Type: Health Applications >> Health Area Type: Websurv >> Request Type: Add Access >> Role: CD_Update >> Reporting Requirements: View Reports

17. Login to WebSurv

18. Login to WebSurv • Password expires every 30 days. • New Users: Initial password is the user’s first and last initials and the last four digits of their SSN. • Users will be required to change their password after initial login. • Password cannot be used more than once every 32 sequences. • Password must contain six characters, at least one number and cannot start with a number.

19. Screen Layout The screen is divided into a header with navigation links and two frames located below the header for navigation and content. • Left frame contains a “tree view” for navigation. The “+” button is clicked to expand the view of an item, while the “-” button is clicked to minimize the item. • Right frame displays the item selected in the tree view.

20. Navigation Header Tree View Content Frame

21. Tree View with Party Info Expanded

22. Tree View with Condition Info Expanded

23. Saving Information To save data, the following must occur on each screen: • Add to list • SAVE! SAVE! SAVE! SAVE!

24. Add to list button Save button

25. Tips • To select items from a dropdown box, users can select the value or type the first letter multiple times until the desired value is found. • Required fields are shown with a red asterisk.

26. Validations When a user clicks the Add to List or Save links, a validation occurs within the application. If errors are present, a validation message will appear in red.

27. Error Message

28. Tips • Click on a column name to sort by that column in ascending or descending order • Click on blue hyperlink to: • Complete task (Add to List, Clear, etc.) • Return appropriate screen (Addresses, Organization Search, etc.) • Click on the calendar icon to return pop up calendar. • When typing in the date, use MMDDYYYY format. Do not use slashes or dashes.

29. Grid Sorting and Navigation Grid

30. Online Instructions Online Manual

31. Entering Notes in WebSurv • Notes can be entered on most screens. • Enter only information relevant to the case – notes may be provided to interested parties under a Sunshine Law request. • Do not specify a source of illness unless there is sufficient evidence to support such a conclusion • Notes cannot be edited. To check grammar and spelling, type out notes in Microsoft Word and use spell check followed by copying and pasting into the note field. • Do not enter condition notes on the History: Notes screen.

32. Notes

33. Disease Specific Guidance For guidance on condition status, diagnostic information, treatments, etc., please refer to the DHSS Communicable Disease Investigation Reference Manual (CDIRM). Or contact the disease investigation staff at your district office (see Contact Information slides). http://www.dhss.mo.gov/CDManual/CDManual.htm

35. Disease Specific Guidance • Diseases entered as OTHER must contain a narrative describing the condition and appropriate lab work if done. • Although reportable, sexually transmitted diseases and environmental related illnesses such as lead, carbon monoxide and arsenic are not entered into WebSurv. • It is not necessary to enter out of state cases into WebSurv.

36. View/Read Only Condition Screens If a condition is not within a user’s jurisdiction or state staff from the district office or Jeff City has set the QA Complete to YES, the user will not be allowed to edit information. Some records may be added (such as diagnostics) otherwise contact district disease investigation staff for assistance.

37. WebSurv Don'ts • Don’t leave system idle for >20 minutes as system will timeout and unsaved data will be lost! • Don’t select a screen in the Tree View without saving information as unsaved data will be lost! • Don’t use the back, forward or refresh buttons in the browser as it may cause data not to be saved and other errors. • Don’t inadvertently change a variable in a dropdown list while using the scroll button on the mouse. (i.e. accidentally reporting anthrax instead of animal bite) • Don’t bookmark pages within the application.

38. WebSurv Don'ts • Don’t use punctuation, the words “and” “or”, nor symbols when entering free text information into the dropdown lists when selecting the “other” option. • This rule does not apply to text entered into the various comments fields.

39. Progress Indicator Warnings If a Progress Indicator is shown on the screen, the user must wait for the system to complete the process. The system has several Progress Indicators. They are: • “Please Wait…” • “Building Page, Please Wait…” • Processing Pyramid popup