Comprehensive Revision of Routine Interstate Duplicate Review Procedures: The New York State Experience

BACKGROUND:   The New York State Department of Health (NYSDOH) participates in the CDC Routine Interstate Duplicate Review (RIDR) project designed to eliminate duplicate reports of HIV cases reported nationally. Twice annually, CDC identifies potential duplicate pairs of cases reported by more than one state and sends lists of these pairs to states for resolution via telephone. Final resolution of “same as” or “different than” status of each pair is entered into the CDC provided Enhanced HIV/AIDS Reporting System (eHARS). Due to methodological changes at CDC, the NYSDOH July 2014 RIDR list was quadruple the typical size, challenging it’s completion by year end.

METHODS:   NYSDOH adapted procedures created by the State of Michigan to resolve the July 2014 RIDR list of 2,022 potential duplicate pairs within the allotted time. A MS Access database and a variety of SAS and SQL programs were used to interface with eHARS for streamlined and prompt resolution. Reports were developed to assess completeness and resolution status by jurisdiction.

RESULTS:  The novel process provided administrative oversight capabilities including queries to assess duplicate pair assignment, resolution status, and detailed reports to track resolution by diagnosis year and state.  Time required for resolution of potential duplicates was markedly reduced via the creation of a form which enabled the comparison of information on one compact display. Data entry after RIDR telephone calls was eliminated with the introduction of real-time input during the interstate calls. In excess of 170 hours of data entry staff time was eliminated. Overall data quality was improved through the use of city, county and zip code lookup tables in the residence and facility address fields as well as a lookup table for HIV test type. Replacing manual data entry into eHARS with a direct import, yielded 100% data accuracy. All pairs were resolved and coded appropriately within eHARS within 5 months of receipt of the RIDR list.

CONCLUSIONS:   The new RIDR resolution process adopted by NYSDOH significantly improved the timeliness, efficiency and accuracy of the resolution of this iteration of RIDR for New York State. Although some technical expertise would be required for other jurisdictions to adopt these procedures, NYSDOH is eager to assist other jurisdictions to implement these procedures to improve the national RIDR resolution process.