BACKGROUND: Disease reporting is a cornerstone of public health surveillance. Currently, case reporting by clinicians is fragmentary and incomplete due to inefficient processes and a lack of knowledge about what conditions to report and what information to include in a report. The Reportable Conditions Knowledge Management System (RCKMS) is being developed as an authoritative portal: a) for communicating which conditions (e.g., diseases or injuries) should be reported in each U.S. jurisdiction, and b) to facilitate reporting through automated identification of persons with reportable diseases using electronic medical records systems. In 2016, the RCKMS team compiled reporting specifications for the 74 conditions that are nationally notifiable and described in a CSTE position statement. Most states require clinicians to report additional conditions based on unique threats in the community, resources, and surveillance needs. In 2017, the RCKMS team will develop reporting specifications for many of these additional conditions. The purpose of this presentation is to report on the status of this effort and describe results of our analysis.
METHODS: We reviewed data from the 2012 CSTE's State Reportable Condition Assessment (SRCA) to identify conditions that were reportable in one or more states, but not nationally notifiable. Each identified condition was categorized by disease type (e.g., STI, enteric disease), the number of states requiring reporting, the relationship—if any—of the condition to a nationally notifiable condition, and the reason(s) that states required reporting. We will repeat the analysis using 2015 SRCA data when it becomes available.
RESULTS: 178 conditions were identified in the 2012 SRCA that were reportable in one or more states, but not nationally notifiable. Of these conditions, 27 (15%) were reportable in 5 or fewer states (e.g., bartonellosis and Chagas disease), and 60 (34%) were reportable in 25 or more states (e.g., amebiasis and galactosemia). The most common categories for these conditions were birth defects, injuries, and vectorborne diseases, although some conditions could be assigned to more than one category. Many of the 178 conditions were related to nationally notifiable conditions or previously—but no longer—nationally notifiable. Strategies for defining the specifications will be shared along with comparative analysis of conditions across jurisdictions.
CONCLUSIONS: Many states require reporting of specific, non-nationally notifiable conditions for a variety of reasons. Health care enterprises that care for patients from more than one jurisdiction need support to meet these requirements. This analysis can inform prioritization, the timely addition of conditions to RCKMS, and the consensus process.