2012 CSTE NEDSS Assessment and Results

Brief Summary
Background The National Electronic Disease Surveillance System (NEDSS) is a standards based architecture that facilitates electronic transfer of  data from the healthcare system to public health departments (Centers for Disease Control and Prevention (CDC)). Public health data can be transmitted to CDC to support the Nationally Notifiable Disease Surveillance System (NNDSS). To evaluate state-level successes and challenges in designing and implementing NEDSS solutions for disease surveillance, the Council of State and Territorial Epidemiologists (CSTE) conducted NEDSS assessments in 2007, 2010, and 2012. Methods The CSTE Electronic Laboratory and Disease Reporting subcommittee NEDSS workgroup, convened  via conference call during January through June 2012. Workgroup members developed the 2012 NEDSS assessment instrument based on previous assessment questions and feedback received from respondents.   The 2012 assessment instrument included questions about system design and capability, NEDSS architectural capabilities, resources and infrastructure, and NNDSS specific questions. Question clarity was improved without sacrificing longitudinal analysis capabilities. The assessment was distributed via SurveyMonkey in August 2012 to all State Epidemiologists and NEDSS Coordinators in all states and the District of Columbia. Results Responses were received by all 50 states and the District of Columbia. Seventy percent of the responders were NEDSS coordinators. Fifty of 51 (98%) jurisdictions reported having a fully implemented and operational NEDSS system; a 25% increase over the proportion reported in 2007. Forty-nine (96%) jurisdictions reported being capable of receiving, processing, and storing electronic laboratory reports (ELRs); a 16.7% increase compared with 2010. Of the 47 jurisdictions that reported they were receiving reportable disease data electronically from laboratories (including hospital laboratories), 28 (60%) reported they could also receive data from hospitals (excluding hospital laboratories), and 17 (36%) reported they could receive data from clinicians. The biggest challenges associated with creating and improving interfaces between NEDSS systems reported included lack of dedicated person hours, funding, other capable systems within jurisdictions, and personnel skills. Conclusions States continue to achieve success implementing the NEDSS framework for integrated electronic disease surveillance. While full implementation has been achieved by 98% of jurisdictions, data exchange capacity and functionality are areas of growth that require continued resources and evaluation. Continued progress in NEDSS data exchange functionality will improve PH’s ability to effectively participate in healthcare information exchange to more efficiently utilize resources and improve the health of the U.S. population.