August 20 2018 Division of Health Informatics and Surveillance NNDSS Modernization Initiative NMI Message Mapping Guide Implementation Technical Assistance Workshop Access the NMI Technical Assistance and Training Resource Center at ID: 771314
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August 20, 2018 Division of Health Informatics and Surveillance NNDSS Modernization Initiative (NMI):Message Mapping Guide: Implementation Technical Assistance Workshop Access the NMI Technical Assistance and Training Resource Center at https:// www.cdc.gov/nmi/ta-trc/index.html Subscribe to monthly NMI Notes news updates at https ://www.cdc.gov/nmi/news.html
Welcome & Updates Purpose of the WorkshopPanel DiscussionPre-Onboarding and ImplementationOnboardingNMI Evaluation Message Validation, Processing, and Provisioning Dashboard FeedbackAsk the Experts Overview of the NMI Workshop
Lesliann Helmus, MSPH, CHTS-CP Associate Director for Surveillance CDC, Division of Health Informatics and Surveillance NMI Updates & Timeline
What NMI Will Achieve One data exchange standard for case notifications Message formats and vocabularies consistent with health careStreamlined and standardized data exchange More consistent, timely and higher quality dataIncreased capacity to use data from EHR systemsRetirement of legacy systems Reduced burden on health department who submit data NNDSS is a CDC collaboration with state, local and territorial health agencies to collect and report data on over 100 notifiable diseases and conditions under continuous nationwide surveillance. 2
Key Components of NMI Develop Message Mapping Guides (MMGs) for case notificationGuidance for how to package case notification dataUses HL7 v2 messages and standardized vocabulariesDevelopment is collaborative effort with CDC programsIncorporates feedback from health departments, APHL, NBSDevelop Message Validation, Processing and Provisioning System (MVPS) Software to receive, check and provide data to the CDC programsProvides feedback to health departments on data quality and completeness Includes Message Evaluation and Testing Service (METS) so that health departments can test messages Provide Technical Assistance (TA) Hands-on assistance to health departments for MMG implementation Provides tools to support independent message implementation Presents training and support webinars 3
Targeting retirement of NNDSS “Modernization”Complete initial disease specific MMG and MVPS work by Dec 2019All MMGs needed to retire NNDSS legacy systems implemented (i.e. those in process) Complete transition of all states to HL7 by Dec 2020 (dependent on resources) All health departments sending all NNDSS data in HL7 Seeking additional resources for jurisdictions for implementationAfter 2020: “Enhancement” mode Add and update MMGs on routine basisImprove NNDSS strategies, processes and technology 4
NMI Implementation Status Aug 13, 2018 PR Production Total of 27 ( 26 states + NYC) Onboarding Total of 7 (states) RI AK WA OR CA MT ID WY NE NV NM TX AR TN ME VT NY FL GA AL NC VA MI PA NJ DE NH CT MA HI AZ LA OK KS CO UT SD MN WI IA MO IL WV MS KY OH IN MD SC ND DC NYC Piloting Total of 2 (states)
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Michele Hoover Lead, State Implementation and Technical Assistance CDC, Division of Health Informatics and Surveillance Purpose of the Workshop
Focus on interactive, peer-to-peer learning. Share the jurisdictions’ expertise about the NMI pre-onboarding, implementation, and onboarding processes. What were some of the barriers and challenges experienced? What are some lessons learned or best practices?What would you do differently? After the workshop there will be an opportunity to have one-on-one consultations with experts and TA team members on experiences that may be unique to individual States. Purpose of the Workshop
The Workshop Schedule Time Topic Speaker/Moderator 8:00 AM-8:15 AM Welcome Attendees Lesliann Helmus 8:15 AM-9:00 AM NMI Pre-Onboarding/Implementation Laura Carlton 9:00 AM-9:30 AM NMI Onboarding Melinda Thomas 9:30 AM-9:45 AM Break 9:45 AM-10:15 AM NMI Evaluation Elandis Miller 10:15 AM-11:00 AM Message Validation, Processing, and Provisioning (MVPS) Dashboard Feedback Andrew Kuehl and Jay Schroeder 11:00 AM-11:10 AM Break 11:10 AM-11:30 PM Technical Assistance and Training Resource Center Feedback Michele Hoover 11:30AM -12:00 PM Ask The Experts Everyone
Who are our Panelists? State Panelists Arizona Teresa Jue Massachusetts Molly Crockett Minnesota Sarah Solarz North Carolina Grace Oguntebi and Lina Saintus Oregon Michelle Barber Wisconsin Amy Bittrich Utah Rachelle Boulton Virginia Rebecca Early, Prabhat Kumar, and Tim Powell
Pre-Onboarding and Implementation Laura Carlton Senior Specialist, Informatics Program Association of Public Health Laboratories (APHL)
Questions and Answers
Onboarding Melinda Thomas, MPH State Implementation and Technical Assistance CDC, Division of Health Informatics and Surveillance
Questions and Answers
Break
Evaluation Elandis Miller, MPH Lead, Message Validation Processing and Provisioning System Council for State and Territorial Epidemiologists (CSTE)
Elandis Miller, MPH 2018 Public Health Informatics ConferenceAtlanta, GeorgiaNNDSS Modernization Initiative Evaluation Update:Using Information to Streamline Notifiable Disease Data Submission NMI Evaluation Workgroup Elandis Miller, MPH Calvin Hightower, MPA Laura Carlton, MPH Melinda Thomas, MPH Michele Hoover, MS Sebastian Romano, MPH Shaily Krishan, MPH
Evaluation Goal CSTE supports NMI evaluation efforts by collecting data from jurisdictions to:Provide input to refine and improve the Message Mapping Guide (MMG) implementation processEvaluate the resources required to complete MMG implementationProvide feedback on tools and resources used to achieve successful onboarding of MMGProvide leadership with information and data to support jurisdictions
Evaluation Data Collection Tools Data Collection Tools Purpose Submission Frequency Time and Cost Log To determine the resources (time, personnel, and cost) required to complete MMG implementation Qualtrics Bi-weekly NMI Experience Assessment To measure the effectiveness of technical assistance and onboarding, and also provide input to refine and improve the processes Qualtrics Once upon completion of technical assistance AND onboarding Qualitative Interview Guide To provide partners and leadership with information and data to support jurisdiction onboarding Phone Once after completion of the NMI Experience Assessment AND onboarding
Time and Cost Log Pilot jurisdictions submit the Time and Cost Log data until completion of UAT. Most money and hours spent on data mapping, vocabulary mapping, data extractionHepatitis/GenV2 Average implementation period: 16 weeks or 156 workdays Average cost: approximately $17,000STD/CSAverage implementation period: 36 weeks or 185 workdays Average cost: approximately $38,000
Data Collection: NMI Experience AssessmentThe NMI Experience Assessment is administered to jurisdictions upon completion of MVPS onboarding, and successful production of MMG HL7 messages. MMG: Hepatitis/GenV2/ArboV1.317 of the 20 jurisdictions have completed the assessments at least once Technical Assistance (TA): Overall, jurisdictions reported high satisfaction with TA, and increased confidence in their capability to implement future MMGs independently. Most utilized resource was technical configuration/ environment setup (NBS only), as well tools and documents for standards/coding and technical architecture/integration Onboarding: Most delays/issues were reported during Step 2: Test Message Validation.
NMI Experience Assessment Findings Mean number of personnel involved in MMG implementation: 4 Mean personnel hours in MMG implementation: 240 64% of respondents utilized internal or central IT services for message transport Mean IT utilization/ IT overhead costs: $41,000 (n=3) 34% of respondents needed to involve contractors/ vendors for message transport Mean contractor/ vendor costs : $25,475 (n=2) T
NMI Experience Assessment Findings Onboarding steps where jurisdictions experienced delays/issues t
Onboarding Step Average number of days to complete step 1. Completing Approved Onboarding Package 18 2. Test Message Validation 35 3. Migration from PHA Test Environment to PHA Production Environment 21 4. Limited Production Message Validation 18 5. Submission and Validation of Year-to-Date File 14 NMI Experience Assessment Findings t
NMI Experience Assessment Findings
t Jurisdictions which have completed the NMI Experience Assessment are invited to participate in a phone follow-up Qualitative Interview (15-30 minutes).MMG: Hepatitis/GenV2/ArboV1.317 of the 20 jurisdictions have completed the assessments at least onceImpact: Improve efficiency in staff time and with reconciliation of data, richer data, quicker adoption of other MMGs, easier close with NEDSS versus NETSS, and standardization in surveillance system. Future Assistance: Message reconciliation, MVPS functionality issues and status of data, lab module, sending batch messages, and alignment of state data collection and MMG requirements. Follow-up Qualitative Interview
Utilization Focused Evaluation The NMI evaluation data has been shared and used to:Plan and Develop:Timelines for onboarding Content for eSHARE callsIdentify:Challenges and issues in MMG onboardingImprove: Communication SchedulingResponse timeMMG onboarding processes MVPS dashboardSimplify Tools and Documents How will YOU use this information?
Conclusion Most money and hours spent on data mapping, vocabulary mapping, data extraction functional areas Estimated time and cost to implement STD/CS is more than double of GenV2/Hep due to complexity of the systems Most delays/issues experienced in Step 2: Test Message Validation of onboarding Planning is key for onboarding: resources (staff, vendors, contractors), time allocation, 1-year backload data, and difficult test cases Utilize the TA team. They are a great resource! Jurisdictions are optimistic that future onboarding of MMGs will improve with each MMG.
MVPS Dashboard Feedback Andrew Kuehl, Lead, Message Validation Processing and Provisioning System (MVPS) CDC, Division of Health Informatics and Surveillance Jay Schroeder MBA , PMP, TOGAF, PSM Deloitte Contractor ISS Requirements Management
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Michele Hoover Lead, State Implementation and Technical Assistance CDC, Division of Health Informatics and Surveillance Technical Assistance and Training Resource Center 2.0
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Technical Assistance and Training Resource Center URL: https://www.cdc.gov/nmi/ta-trc/index.htmlAvailable Now!
Ask the Experts
Brett Armstrong (WV) Michelle Barber (OR)Amy Bittrich (WI)Rachelle Boulton (UT)Hwa-Gan Chang (NY)Jim Collins (MI)Sherri Davidson (AL)Rebecca Early (VA) Annie Fine (NYC)Greg Fowler (SC) Janet Hamilton (FL)Gillian Haney (MA)Shannon Harney (TN) Tamara Hennessy-Burt (CA) Nick Hill (SD) Teresa Jue (AZ)Judy Kauerauf (IL)Theresa Kittle (MS) Erin Metcalf (NH)Andrew Rentschler (DE)Dale Rohn (MD)Shannon Sandall (KS) John Satre (IA) Sarah Solarz (MN) Megan Tompkins (AK) Kathy Turner (ID) Special Thanks to State and Local Partners
Special Thanks Association of Public Health Laboratories Technical Assistance TeamLaura CarltonCorey Cooper Susan DownerHeather HoustonMelanie KourbageJohn Park Natalie Raketich NEDSS Base System Team Christi HildebrandtAkshar Patel Jennifer WardMichael Wodajo CSTE Meredith Lichtenstein Cone Shaily Krishan Elandis Miller
Special Thanks CDC Partners Deborah AdamsAndrew KuehlJason HallLesliann HelmusBen KupronisCraig MincicDiana OnwehSebastian Romano Sandy RoushMark Stenger CDC NMI Technical Assistance and Onboarding Team Calvin Hightower Noreen KlocHang NguyenTamara Robinson Melinda Thomas
Subscribe to monthly NMI Notes news updates at https://www.cdc.gov/nmi/news.html Access the NMI Technical Assistance and Training Resource Center at https:// www.cdc.gov/nmi/ta-trc/index.html Request NMI technical assistance or onboarding at edx@cdc.gov Next NMI eSHARE is August 28, 2018–details at https:// www.cdc.gov/nmi/eshare.html Additional Questions?