Streamlining Class AB TB Reporting through Electronic Data Transfers

BACKGROUND: In 2012, Massachusetts began an electronic transfer of all refugee arrival notifications from the CDC’s Electronic Disease Notification (EDN) System into its statewide surveillance and case management system, the Massachusetts Virtual Epidemiologic Network (MAVEN).   The EDN system is also used by CDC to notify states of immigrants and refugees who have had TB conditions identified during the overseas medical examination and require follow-up in the United States (Class A/B TB). In 2014, the Office of Integrated Surveillance and Informatics Services (ISIS) in conjunction with the Division of Global Populations of the Massachusetts Department of Public Health (MDPH) expanded the electronic data transfer to include Class A/B TB notifications.  

METHODS: For refugee notifications, the EDN electronic feed creates refugee and refugee family records in MAVEN based on case file numbers assigned during overseas processing.  Because arriving immigrants do not have case file numbers, ISIS developed an algorithm based on several TB fields in the EDN documents.  If a refugee or an immigrant fits the algorithm, a TB record is created in MAVEN.  After the feed has created records in MAVEN, an automated process links each refugee record to their respective refugee family record and, if created, to their TB record.  All attachments downloaded from the EDN system are electronically attached. 

RESULTS: In 2013, 2065 refugee records and 372 Class A/B TB records were created in MAVEN.  Approximately 83% of the refugee records and 0% of the Class A/B TB records were created by an electronic feed.  In 2014, 311 Class A/B TB records were created, of which 176 were created after the implementation of the electronic feed for Class A/B TB notifications.  Among the 176, 96% (N=169) were created by the EDN feed.

CONCLUSIONS: With the implementation of the new electronic feed for Class A/B TB notifications, Massachusetts, through MAVEN, is able to simultaneously notify all pertinent state and local users of newly arrived refugees and immigrants, allowing for prompt follow up care.  It also assures that pertinent demographic and case history information is stored in a central repository, where it can be linked to other information pertinent to the ongoing case management.