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

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Table

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Patients ExitingPOD

Medical Counseling Area

Table

Table

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Mental Health Area

Meds Dispensing / Vaccination Area

- Staff - Patient

6

12

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# - Number of stations

2

2

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Medical Screening Area

CRAData Entry

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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