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2008 Vaccine Doses Administered Exercise (DAX)

Discussion of Option 1: Data Exchange Using CDC’s CRA System and State Immunization Information (IIS) or Other Existing Systems

June 11, 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• Aggregate Reporting Options • Details on Option 1 of CRA System• CDC Resources and Contacts• Questions and Answers

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Learning Objectives

• Understand Option 1 and the various formats that may be used to report to CRA system

• Understand the operational steps and decisions to be made for Option 1

• Understand the CDC technical support available for Option 1 of CRA system for aggregate reporting

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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

• 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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Option 1: Data ExchangeSummary• Healthcare provider collects and maintains

patient-level information locally and submits selected data to the IIS or other application

• The state submits aggregate data to CDC’s CRA system on a weekly basis via Immunization Information System or other application using one of three data exchange formats:• Flat file (pipe-delimited) OR• Extensible Markup Language (XML) file OR• Health Level Seven (HL7) Version 2.5

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Option 1: Data Exchange (continued)

Process Considerations• What level of vaccination data and

by whom it will be collected must be determined; at minimum, core data elements must be collected

• Aggregate data exchange must be consolidated at the project area prior to submission to CDC

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Option 1: Data Exchange (continued)

Technical Considerations• Local application should have capability to

collect core data elements• Core data elements should be extracted and

put into one of three formats following the Data Exchange Specification for Pandemic Influenza Aggregate Report

• Transport mechanism should be determined and consistent with CDC PHIN standards

• CDC SDN Digital certificates must be in place for access and transfer to CRA

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Option 1: Data Exchange (continued)

Transport Mechanism Considerations• If using ebXML as a transport mechanism:

• Obtain and register a Party ID with CDC-CRA• CRA will facilitate obtaining the Party ID

• PHINMS is available for project area installation; CRA will facilitate connecting the project area with PHINMS technical assistance

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Option 1: Data Exchange (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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Option 1: Data Exchange (continued)

Guidelines for Reporting Aggregate Data• Each project area sending data to the CRA system

is responsible for submitting one set of counts for each reporting period that aggregates all the doses administered for the eight exercise clinics in the project area

• Reporting is required for each reporting period during the event, even if no doses were administered

• Reporting period is based on the MMWR week; defined as Sunday through Saturday

• Reporting is required by close of business on the Tuesday following the end of the reporting period

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Option 1: Data Exchange (continued)

Full Replacement of Aggregate Reports• Full replacement of all aggregate counts

already submitted along with the new aggregate counts is required for each reporting period

• Aggregate counts are replaced based on a match to the partner, event, start date, end date, and vaccine type

• Each week, submit the counts for the new week plus the counts for each previous week

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Option 1: Data Exchange (continued)

Aggregate Reporting

Full Replace

Doses Administered per Week

Week 1 – Doses

Administered

Week 2 – Doses

Administered

Week 3 – Doses

Administered

Week 4 – Doses

Administered

Week 1 Report 100

Week 2 Report

105(week 1 data

updated with 5 more doses

250

Week 3 Report

105(no change from previous week)

250(no change from previous week)

100

Week 4 Report

105(no change)

200(week 2 data

updated with 50 fewer doses)

100(no change)

375

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CDC Technical Support

• Download the Data Exchange Specification for Pandemic Influenza Aggregate Report document from the CRA PHIN website (http://www.cdc.gov/phin/activities/applications-services/cra/2008Exercise.html)

• 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)

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Option 1: Action Items

• Identify a Point of Contact (POC)• Confirm decision to use Option 1• Select the content format your

system will use (Pipe Delimited, XML, HL7)

• Select the method your system will use to transfer information (Message, Upload)

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Option 1: Action Items (continued)

Data Exchange Development by August 29• Develop any necessary code to create the

selected file format and transport the file to CRA

• Send a test file for evaluation after development of code• If using PHINMS Message to transfer the file,

confirm that you have a digital certificate to send messages using PHINMS

• If using CRA Upload to transfer the data file, confirm that the user who will be uploading the file has a digital certificate, is assigned to the CRA Application, and has been loaded into the CRA Application with the PHA user role

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Option 1: 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 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

June 24 Webinar Option 2 and 3 Users

July 9 Webinar Option 1 Users and Exercise Status Report

July 23 Webinar Option 2 and 3 Users and Exercise Status Report

August 6 Conference Call General Information and Questions

August 21-22

Doses Administered and Safety Training Conference

Doses Administered Reporting Training and 2008 Exercise

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?