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Doses Administered Exercise DAX 2008

Doses Administered Exercise DAX 2008. Webinar Presented February 11, 2009 Joint Presentation by: Division of Emergency Preparedness and Response National Center for Public Health Informatics and Immunization Services Division National Center for Immunization and Respiratory Diseases.

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Doses Administered Exercise DAX 2008

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  1. Doses Administered ExerciseDAX 2008 Webinar Presented February 11, 2009 Joint Presentation by: Division of Emergency Preparedness and Response National Center for Public Health Informatics and Immunization Services Division National Center for Immunization and Respiratory Diseases

  2. Agenda • Background • Results • Feedback • Open Question & Comment • Next Steps

  3. 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, collect and aggregate minimum data elements and transmit weekly to CDC • CDC’s CRA system was modified to provide three ways for states and partners to report vaccine doses administered

  4. Aggregate Reporting Options via CRA The file is then securely transferred to CDC via either CRA application or PHIN MS and loaded into CRA for reporting State enter data into state’s Immunization Information System or some other equivalent application and is extracted in one of these format. Pipe-delimited File XML File Option 1 Data exchange CRA HL 7 Data is available in CRA for reporting Aggregate data entered directly into CRA via the web-based aggregate reporting interface CRA Option 2 Direct web entry Individual level data is entered directly into CRA via the web based flexible Treatment interface Individual level data are automatically aggregated by CRA system and is available for reporting Option 3 Individual level data entry CRA

  5. PI Vaccine Doses Administered Minimum Data Set for Reporting to CDC • Project Area ID • Reporting Period Start and End Dates • Vaccine Type (CVX code) • HHS Pandemic Priority Groups • Homeland and National Security • Health Care and Community Support Services • Critical Infrastructure • General Population • Dose # • Count of Doses Administered per Priority Group and Dose #

  6. DAX 2008 Summary The 2007 pilot had very basic objectives for: Project areas to demonstrate their ability to collect and report doses administered to the CDC CDC to demonstrate the CRA systems capability to accept and aggregate data The 2008 exercise expanded on these objectives to more closely match pandemic conditions: Weekly reporting Increased volume Priority group tracking

  7. DAX 2008 Requirements • To be considered fully successful, Project Areas had to meet the following criteria: • Weekly reporting: for any four consecutive weeks between Oct. 1 – Dec. 31, doses administered had to be sent by on Tuesdays by 11:59 pm (in Project Area respective time zones) for the previous reporting week (based on MMWR week of Sunday through Saturday); • Increased volume: data had to be sent from a minimum of eight clinics over the four weeks • Priority group tracking: priority groups had to be tracked for the general population

  8. COTPER Bio-Surveillance Requirement • Project Areas were required to participate in DAX 2008 to meet the PHEP cooperative agreement bio-surveillance exercise requirement • Where applicable, Project Areas needed to send vaccination data from at least one clinic in CRI MSA, and one in non-CRI MSA

  9. Homeland and Nations Security Tier 1 (HNSt1) Tier 2 (HNSt2) Tier 3 (HNSt3) Health Care and Community Support Services Tier 1 (HCCSSt1) Tier 2 (HCCSSt2) Tier 3 (HCCSSt3) Critical Infrastructure Tier 1 (CIt1) Tier 2 (CIt2) Tier 3 (CIt3) General Population Tier 1 (GPt1) Tier 2 (GPt2) Tier 3 (GPt3) Tier 4 (GPt4) Tier 5 (GPt5) Overall Proposed Doses Administered Category and Tiers for Data Reporting

  10. 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 • Receive clinical data from 62 project areas • Webinars-Option specific; DAX updates; open Q&A; option specific final exercise preparations • Exercise support & trouble shoot • Develop After Action Report • Develop feedback questionnaire • Conf. Calls-Individual project areas; follow up for Q&A • Briefings and conf. presentations • PHIN conference • Development & Deployment-Version 1.8 release • Selection of POC • Screen for priorities groups • Submit doses administered data to CDC via CRA • Respond to feedback questionnaire • Identify & submit option choice • Finalize & submit reporting weeks & clinic location (including CRI) • Participate in After Action Review • Review option guide • Obtain digital certificates

  11. DAX 2008 Results

  12. Option Choice Breakdown

  13. DAX 2008Option Choices by Project Area American Samoa Marshall Islands Guam Mariana Islands Virgin Islands Palau Puerto Rico FS Micronesia Chicago NY City DC LA county Data Exchange Web Entry aggregate Web Entry Detail

  14. Aggregation Method Among Web Entry Aggregate Users (Option 2) * Data for 2 project areas has not yet been received

  15. DAX 2008 vs. 2007 Pilot *DAX 2008 requirements were considerably more complex than for Pilot 2007; this table shows increases/decreases in comparable activities; however, the activities themselves are not equal in magnitude †Data on meeting the bio-surveillance exercise requirement have not yet been confirmed for 2Project Areas

  16. Reporting Timeliness by Method

  17. Delay Indicator Through Reporting Period DAX 2008

  18. Feedback Poll • Project Areas were asked to complete anonymous, on-line feedback poll • Ten questions highlighting: • CRA ease of use • Efficiency of communication from CDC • Benefits of exercise • Issues/barriers encountered • Collaboration between Immunization and Emergency Preparedness • Feedback to improve future exercises

  19. Question: How easy was CRA to use to transmit/enter and submit data to CDC? 30 respondents – Very Easy 17 respondents – Somewhat Easy 4 respondents – Not Easy

  20. Question: How beneficial was this exercise test to you in preparing for a pandemic influenza event in the future? 24 respondents – Very Beneficial 25 respondents – Somewhat Beneficial 3 respondents – Not Beneficial

  21. Question: Has DAX 2008 helped to improve communication/coordination between Immunization and Preparedness branches/sections at your health department? 37 respondents - Yes 15 respondents - No

  22. Question: What issues, if any, did you encounter while transmitting data to CDC? • 15 respondents – Digital Certificate Issues • 16 respondents – Coordination with Local Health Departments or clinics • 3 respondents – SDN Issues • 13 respondents – Technical Issues • 5 respondents – Data File Formatting (Option 1)

  23. After Action Review Call Feedback Confirmed findings from Feedback Questionnaire Digital certificate process was a concern (refactoring with base system underway) The business rule that did not allow Project Areas to submit data before the end of the reporting period was cumbersome Supplemented findings from Feedback Questionnaire CRA was easy to use CDC/CRA support was good (technical and project) Communication was good throughout exercise

  24. Total Data Submitted for DAX 2008

  25. Lessons Learned • Linking the exercise to the PHEP cooperative agreement helped increase communication and interaction among preparedness and immunization staff; it is also important the program and preparedness requirements are consistent from • Increased frequency of communication via webinars, conference calls, one-on-one calls was effective in increasing participation • The screening requirement is challenging; Project Areas need efficient priority group screening methods; CDC may be able to assist by providing ‘best practice’ examples, facilitating discussion • The Vaccine Doses Administered and Safety Training Conference in August 2008 helped in understanding project areas needs and ways to fill gaps

  26. Plans for 2009 • Repeat to better measure progress using DAX 2008 as a baseline for comparison • Ensure requirements are consistent among immunization program and preparedness • Continue to seek supplemental funding opportunities to assist Project Areas • Continue to provide educational opportunities (i.e. conferences, meetings, etc.)

  27. Questions or Comments?

  28. Question: How beneficial was this exercise test to you in preparing for a pandemic influenza event in the future?

  29. Question: What issues, if any, did you encounter while transmitting data to CDC?

  30. Question: How adequate was the introduction and initial communication?

  31. Question: How adequate was the support from CDC in preparing for and during exercise?

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