State health department captures more complete and timely data on highly transmissible diseases through eCR implementation

Client background   

A state-operated department of health that is focused on improving the health and well-being of residents by using science and community engagement to help prevent disease and enhance quality of life.  

The business challenge 

The client was looking to gain insight and improve its syndromic surveillance of high transmission diseases, including COVID-19, with strategic leadership and focus from their epidemiology stakeholders. To help with this mission, the state agency implemented electronic case reporting (eCR) to gain an understanding of the data contained in the case reports and improve upon the reportable conditions that can be tracked and made available to them as a public health agency.  

The client decided on a phased approach to consume the eCRs and send them to an internally developed SQL database in the initial implementation, and then have them delivered to an enterprise-level surveillance system in a future phase. Obtaining the eCRs required collaboration with the clients health information exchange (HIE), which captured the case reports from participating hospitals, specialty centers and clinical facilities throughout the state’s public and private health infrastructure. To help with developing an integration solution, the client sought outside guidance from a professional organization that had prior experience with this type of system implementation.  

The Baker Tilly approach   

Baker Tilly was already engaged with this client for additional consulting and integration services and the client decided to include Baker Tilly as their trusted advisor in their eCR integration project as well. A healthcare and integration consultant was immediately assigned to the engagement and began to define the project scope, identify the stakeholders, obtain an understanding of data and networking components, and review the Extensible Markup Language (XML)-based eCRs to determine their structure and the epidemiology-requested fields desired for the database.  

Working closely with the internal staff, the state HIE and strategic Centers for Disease Control and Prevention (CDC) vendors, Baker Tilly helped with developing a Rhapsody-based interface that: 

• Consumed and parsed the eCR-XML messages 
• Extensively tested the four types of eCR messages 
• Completed JavaScript filtering and extraction of reportable conditions 
• Modified and mapped the XML messages for SQL database population 

Documentation and training were also provided to the internal staff on both the eCR and the Rhapsody interface solution for future support and growth. 

The business impact   

The state successfully implemented its eCR system with its syndromic surveillance platform. With the successful implementation, the database solution provided the client with the ability to perform tasks such as additional COVID-19 surveillance, queries on patient demographics, and the ability to identify spikes in specific disease reporting. It also positioned the client for integration with future enterprise surveillance systems as well as for other CDC and public health initiatives.   

For more information on this topic, or to learn how Baker Tilly’s healthcare information technology specialists can help, contact us now.