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Infrastructure Questions
The National Notifiable Diseases Syndromic System (NNDSS) Infrastructure Questions can be used to help a public health agency (PHA) assess the overall infrastructure and available resources to implement case notifications. Areas covered include current state of information systems, technical architecture, a high-level overview of the PHA surveillance system, and terminology-related questions.
TECHNICAL ARCHITECTURE QUESTIONS
- What surveillance system are you using?
- How do you extract disease-specific case information from your surveillance system? How are these extracts stored? Are they manual or electronic; what is the frequency with which extracts are generated? What is the process for corrections and edits?
- What is the current process to send case notifications to CDC?
- Do you use an integration engine for NNDSS (e.g., Rhapsody, MIRTH, multiple)?
- What are the HL7 versions (e.g., 2.3.1, 2.5.1) and message types (e.g., ORU, OML, OUL, ORM) that are currently supported, if any?
- Do you use different surveillance systems for different diseases?
- Are there any limitations for access to surveillance systems, integration engines, databases, or other components involved in your case notification reporting route?
- Have you gathered necessary documents (technical architecture diagrams, local mapping data dictionaries, etc.) that may be needed?
- Do you have staging (test environment) and production environments available?
- Does your organization require a separate test evaluation and acceptance testing processes before software can be rolled out to production?
- Does your staff have direct access to systems needed to make changes to data streams? If not, will contractors/vendors be needed?
TECHNICAL ARCHITECTURE: TRANSPORT QUESTIONS
- What is your current transport mechanism for reporting?
- Will you use the PHIN Messaging System (PHINMS) to send HL7 messages?
- Do you currently use the APHL Informatics Messaging Services (AIMS) Hub?
TECHNICAL ARCHITECTURE: PERFORMANCE QUESTIONS
- What is your estimate of the overall volume and frequency of reportable condition data?
- Are there other notable applications running on the system that may influence system performance (e.g., hardware)?
VOCABULARY: BACKGROUND QUESTIONS
- Are standard CDCREC codes used for race/ethnicity (Race Category and Ethnic Group Code)? What alternate code(s) and/or free text are available?
- For fields populated from a predefined list of answers (i.e., dropdowns), do you have codes available? Are the codes in use standardized?
- Do you have a process for updating/maintaining standard and/or local codes and value sets? If so, what process and sources are used (e.g., PHIN Vocabulary Access and Distribution System [PHINVADS], Reportable Condition Mapping Table [RCMT], official standard code distributions including Regenstrief Institute for LOINC and NLM for SNOMED CT, other)?
- In what formats do you receive data from local health departments, hospitals, etc? Are any of these data received in a coded form? Is further normalization/coding/translation/mapping done after receiving the data (e.g., in surveillance system, integration engine, other)?
- Can you access raw laboratory data for NNDSS reporting (e.g., from your electronic laboratory reporting [ELR] feed)?
- Which value sets and/or free text are available for lab tests (e.g., LOINC, SNOMED CT, local codes, free text)?
- What value sets and/or free text are available for non-numeric lab results and interpretations (abnormal flags) (e.g., organisms, descriptive, categorical, pos/neg)?
- Are standard codes (SNOMED CT or HL7) used for specimen source/type? What alternative code(s) and/or free text are available?