TM 1 Countermeasure and Response Administration Working Group Webinar Webinar Presented July 30,...

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TM1

Countermeasure and Response Administration Working Group

Webinar

Webinar Presented July 30, 2008

Jeanne Tropper, MS, MPH jwu0@cdc.gov&

CRA Development TeamDivision of Emergency Preparedness and

ResponseNational Center for Public Health

Informatics

TM2

Agenda• Purpose• Background of CRA• V1.8 New Features and

Demonstration• Question and Answer • Discussion of V1.9 Topics• Question and Answer • CRA Working Group Organization and

Schedule

TM3

Purpose

• Foundation for All Hazards support near completion

• V1.9 likely last release before migrating to open source (OS) environment; closer alignment with OMS and Epi Info ™

• Formalize process for prioritizing development of final release

• Position CRA to move to Outbreak Management Community of Practice (CoP) governance structure

TM4

What is CRA?

• Genesis was Pre-Event Vaccination System (PVS) for national smallpox vaccination campaign

• Capability to support mass tracking during an event

• System has since evolved to support any countermeasure, any event; may include medical interventions such as vaccinations, pharmaceuticals and non-medical interventions such as patient isolation and quarantine or social distancing measures

• Includes the ability to track both detail (person level) and aggregate counts of countermeasures

TM5

Implementation Options

• Centralized implementation – application is centrally located and managed by CDC; accessible using any standard web browser in conjunction with a CDC issued digital certificate

• Offline implementation - new with V1.7, CRA may be deployed offline on a stand-alone basis

TM6

What is New with CRA?

• V1.8 due for release September 15, 2008• Aggregate Group & Reporting

Enhancements (with Data Exchange)•Priority groups•National reporting

• Adverse Event Support• Patient Follow-up• Event Reports/Data Extracts

Enhancements• Sub-jurisdiction Support• User-Defined Fields Support

TM7

Definitions

• Countermeasure – intervention taken to help prevent and/or slow the spread of disease; countermeasures may include medical interventions such as vaccinations, pharmaceuticals and non-medical interventions such as patient isolation and quarantine

• Event – public health programs or emergency responses that require the administration of countermeasures

• User Roles – CRA has role based user access; the user can only access system functions appropriate to their role; two roles• Public Health Administrator (PHA)• Data Entry Specialist (DES)

• Aggregate Reporting – CRA has updated to support project areas reporting a subset of data to the CDC; the capability was established to support vaccine doses administered during a pandemic; however, it could be applied to any situation

TM8

Table

Table

Table

Table

Table

Table

Table

Table

Table

Table Table

Patients ExitingPOD

Medical Counseling Area

Table

Table

Table Table

Mental Health Area

Meds Dispensing / Vaccination Area

- Staff - Patient

6

12

Table

Table

Table

# - Number of stations

2

2

4

Medical Screening Area

CRAData Entry

Station

Yes

M

eds/

Vac

cina

tion

No Meds/ Vaccination

Routine

DoorDoor

DoorDoor

Door

Pa

tien

ts E

nte

r PO

D

Door

Door

POD Patient Flow

Table Table

LEGEND

Door

Special

Sp

ecia

l

TM9

Anthrax Scenario

• Multi-city event with affected populations in Washington, DC, New York City and Florida

• Scope of attack unknown; post exposure prophylaxis advised

• Central dispensing center established

• Emergency supply of antimicrobials ordered

TM10

CRA Demonstration

• Anthrax Event in Washington, DC• Demonstrate person data entry

process•Data entry of patient

countermeasure •Data entry of patient registration

• Demonstrate patient import feature – mail handlers

TM11

Teen Vaccination Scenario

• Campaign to administer vaccines to pre-teens and teens in Long Beach School System

• Vaccination centers established in three middle schools

• CRA used for follow-up with students receiving HPV vaccine

TM12

CRA Demonstration

• Teen Vaccination Event • Demonstrate data entry of

vaccine with follow-up dose schedule

• Demonstrate process to record adverse event

• Demonstrate event set up and ability to customize screens • View follow-up configuration• Add user defined field

TM13

CRA Future Development Topics

Head of Household Dispensing • Look at all household dispensing options; group

patients by family

Alternate Data Entry • Use barcode scanners, handwriting recognition;

allow multiple data entry points, such as intake and dispensing; allow use of CRA on handheld devices

Ability to Exchange Data with Other PH Systems including but not limited to Immunization Registries, Surveillance, Outbreak Management Systems

• Aggregate and line listed bi-directional data exchange in multiple formats

TM14

CRA Future Development Topics, Continued

Population Health Management• Provide for import of population registries - nursing

homes, hospital staff, EMS, etc; track denominator data; patient de-duplication/merge

Data Elements for Patient Intake/Screening • Risk factors; prior and current medical conditions;

contraindications specific to countermeasures of interest

CRA, Epi-Info, OMS Integration – what form should it take• Bi-directional data exchange among applications; use

standard architecture; same look and feel of applications; developing user-defined variables/questionnaires/forms

TM15

CRA Future Development Topics, Continued

Support Linkages with Strategic National Stockpile and Other Inventory Tracking Systems

• Support linkages with inventory systems; deployment of CRA with SNS Push packs preloaded with countermeasure information

Analysis, Visualization and Reporting • GIS capability; add query function; access to data

entered into online and offline CRA; add staff management reports, duplicate identification, clinic and sub jurisdiction countermeasure administration, etc; print user record prior to countermeasure dispensing

TM16

CRA Future Development Topics, Continued

Provide a Patient Consent Form • Document permission for countermeasure

administration, follow-up, tracking and Epi research

Decentralized Deployment• Export data from off line installations to CDC

and other localities; preload user, organization , and event data through import or batch entry; automate updates of offline installations; enhance offline system security ; enhance data encryption ; offer offline Web access and standalone access

TM17

CRA Working Group Organization

• Development of Working Group Charter• Generation of meeting minutes• Development of committees• Becoming a part of the Outbreak

Management CoP• CRA Working Group Webinar August 13,

2008• Workshop at PHIN Conference Tuesday,

August 26, 7 am • Review prioritized enhancements• User feedback in focused areas, e.g.,

reporting, person-level data entry, other

TM18

Getting Started with CRA

• Consider using during an exercise• Demonstration version will be

available for partner “try outs”• CRA training available• PHIN Help Desk first line of contact

for accessing CRA• Telephone 1-800-532-9929: 8 AM to 8

PM EST •  Email:  Phintech@cdc.gov