October 2021

Reminder for Jurisdictions about the Low-incidence Case Verification Process

Effective August 14, 2021, jurisdictions and CDC programs should use the Message Validation, Processing, and Provisioning System (MVPS) portal to verify low-incidence cases:

• When CDC receives a notification that meets the criteria for low-incidence case verification, MVPS will automatically email the jurisdiction requesting that you log into the MVPS portal to verify the case. The email from MVPS will include the CASE ID, condition name, and event code.
• Use the information in the email to search for the case in the low-incidence window and select a verification response.
• Verification responses include “under investigation,” “do not publish,” and “approved” for publication.
• MVPS will send weekly reminders for two weeks about any cases that need verification. If you have not entered a response after two weeks, NNDSS staff will contact you to request that you enter a low-incidence case verification response.

To learn more about the low-incidence case verification process, visit our archive of the August 10, 2021, eSHARE webinar for:

• a presentation providing an overview of the low-incidence case verification process (see slides 74-86) and
• a job aid for jurisdictions with instructions for how to use the MVPS portal to verify low-incidence cases. Learn how to get access to job aids on MVPS.

New Report Makes Recommendations for Modernizing Public Health Data Systems

As part of the Data Modernization Initiative, CDC encourages jurisdictions to re-think and re-design their information systems using the funding provided through the Health Information Systems component of the Epidemiology and Laboratory Capacity Cooperative Agreement.

As previewed in the May issue of Case Surveillance News, NNDSS asked the Public Health Informatics Institute (PHII) to develop recommendations for jurisdiction public health systems, recognizing that the original National Electronic Disease Surveillance System standards from 2001 are 20 years old. NNDSS asked that PHII engage stakeholders and experts, consider a time horizon of 5–10 years, and focus on functionalities and capabilities.

PHII developed recommendations using information gathered through listening sessions and validated them with an expert panel. The PHII report points out the importance of addressing the organizational, interorganizational, and workforce aspects of modernization, as well as technical aspects. The report also addresses the importance of achieving balance between jurisdiction needs and national harmonization.

These recommendations will be integrated with the CDC Data Modernization Initiative’s emerging data ecosystem vision and other data system and surveillance recommendations to produce one set of coordinated guidance for surveillance systems.

Read PHII’s recommendations at Data Modernization Initiative: Case-based surveillance capabilities and technology recommendations.

Highlights of PHII’s recommendations may be useful in your current planning:

1. Establish automation through integration—Separate systems need to become more integrated and interoperable to achieve efficiencies. This will support a better and more timely flow of data and leverage investments by building a service once and using for multiple health department functions.
2. Balance the push and pull—Develop the ability to pull data from electronic health records or other public health systems rather than waiting on a push of information. This may make data timelier, is likely to allow better control over data flow and processing, and may reduce the reporting burden for healthcare.
3. Use artificial intelligence (AI)—AI might help public health handle large volumes of data more effectively and could support predictive analytics to enable public health to be more proactive. PHII acknowledges that while AI offers opportunities, other foundational improvements are more pressing.
4. Establish uniform system standards and functionality—More consistency among systems would help support integration. This should include standardized functional requirements, technical requirements, and ways of collecting data across programs. Uniform system standards and functionality would make it easier for healthcare to interact with public health and for jurisdictions and jurisdiction programs to share data and resources. The recommendations emphasized centralized services, such as Reportable Conditions Knowledge Management System (RCKMS), and adoption of standards, such as Fast Healthcare Interoperability Resources (FHIR).
5. Harmonize data across public health programs—Improve semantic interoperability and use  common data standards such as United States Core Data for Interoperability (USCDI).
6. Ensure flexibility and modularity of systems—To be more flexible, think of functions instead of systems, use modular design, and increase interoperability using application programming interfaces.
7. Support scalable systems—Systems should be readily scalable to meet demands. Use of cloud services is important for achieving this.
8. Improve entity and patient matching—Current approaches to matching records on individuals are a time drain and a hurdle to integration. Use agency-level master patient indexes supported by record locator services and identify cross-jurisdiction solutions.
9. Improve partnerships and cross jurisdictional coordination—Relationships are important. The ability to share data across jurisdiction borders needs to be a fundamental requirement. Trusted sharing frameworks such as Trusted Exchange Framework and Common Agreement (TEFCA) will be important.
10. Support intensive data access required for dedicated query systems—Use data lakes and data warehouses to improve access to and use of data.
11. Streamline or simplify data transport—Get as much data through one pipe as possible and standardize expectations. This would help healthcare and create efficiencies for public health.