BACKGROUND: In Alabama, shiga toxin-producing Escherichia Coli (STEC) investigations require an additional paper form to collect detailed exposure information as outlined in the 2013 CSTE Position Statement. ELC grant requirements reinforce the need for collection of the 47 data elements. In 2016, 124 STEC investigations were completed by the state’s Area Investigators (AIs), who conduct disease investigations for general communicable diseases that are notifiable; these are subsequently reviewed by Central Office staff. In efforts to condense the amount of steps needed to collect the information, the Alabama Department of Public Health, Infectious Diseases & Outbreaks Division (ID&O) Analysis & Reporting Branch (A&R), began development of the STEC disease module in the NEDSS Base System using the Page Builder technology, in conjunction with IT staff. In early 2017, the STEC page will go into production and provide a simpler, yet stout investigative process.
METHODS: The Generic v2.0 Message Mapping Guide was utilized initially in the process, incorporating all standardized questions and related value sets and concepts into the STEC page. State-specific questions and CSTE disease-specific data elements were included on the page. Legacy data was mapped by program staff, with tools provided by IT. Once the draft page was published, AIs pilot-tested the page to test logical flow of questions, review for any discrepancies, and provide feedback. After piloting, IT began the process of preparing the page for production.
RESULTS: The overall steps needed to notify the CDC of a STEC case will be reduced from 7 to 4 steps and will eliminate paper, once STEC is in production. Additionally, the number of required exposure questions (including food and travel histories) that were captured previously increased from 8 to 47. Three of four AIs that piloted the page reported ease of use. Minor issues were reported, such as amount of space available for certain text fields. These issues were fixed prior to preparation of the page for production.
CONCLUSIONS: Though the number of steps involved pre- and post-production of the STEC page may appear minimal, the burden of conducting STEC investigations in duplicate to collect required information will be alleviated. Positive feedback regarding the new disease module provides incentive to move the page into production expeditiously. Though there has been an increase in the number of questions required to create a notification, it is recognized that more robust information will be obtained, further contributing to epidemiologic data for STEC.