National Electronic Disease Surveillance System (NEDSS ...

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PHASE II Task 3 Deliverable of the system to include other BOH databases. If the increase is sufficiently large, it could necessitate changes in system architecture to accommodate the increased user demand. While system architectural changes and programming could be costly, the alternative of decreased user service through increased processing time, an insufficient number of data ports to support user access, and/or diminished public health responses resulting from the inefficient and ineffective utilization of the query and reporting functions are significantly more unacceptable and must be avoided. V. Interdependencies Through the Maine Bureau of Health, NEDSS data will be linked to other databases and to a network of providers and public health agencies. Thus, BOH works with the various provider and public health organizations in developing procedures and policies for data collection security, and access. These provider and public health entities rely on this web-based access (read only format) for accurate and timely data that can be incorporated, through the e-business functions, into reports and other information (e.g., Health Advisory Notices) for dissemination to these various entities to protect the public health and to effectively manage public health programs and provider practices. As such, each government, provider, and public health entity shares responsibility for data accuracy, the appropriate and ethical use of the data, and the responsible public health, clinical, and managerial application of the resulting data-derived information. VI. Organizational Structure The e-business query and reporting functions are incorporated under NEDSS, and therefore housed under the Maine Bureau of Health organizational design. Management authority and responsibility for the technical components and data elements will lie with the Division of Disease Control (DDC). The DHS Department of Technical Services (DOTS), a key stakeholder, will play an advisory role in the development of the system so that it can communicate as appropriate with current and planned systems and technology. VII. Leadership and Governance As noted above, structural and programmatic responsibility for NEDSS resides with the Division of Disease Control, Maine Bureau of Health. This arrangement provides for the data development and access to the data by the community of users, but it does not address the issues surrounding the e-business query and reporting functions for the user community. In addition to the monitoring of system usage provided by DDC and BOH, the e-business functions require an additional layer of leadership and governance to address management and public health issues. To ensure effective, responsible, and equitable use of the data and their resultant reports developed by the user community, the Maine BOH should establish an NEDSS Advisory Council, comprised of representatives from the various stakeholder and user community constituents. Members could include representatives from the Bureau of Health, laboratory providers, clinical providers, hospitals, legislators, public citizens, and other stakeholders. Terms could be staggered, with a chairperson designated from the members, possibly rotating to different member constituents. The Advisory Council could be responsible for providing general direction and representation issues, developing data access and dissemination policies, reviewing requests for collecting additional data, benchmarking and PHRG 4 of 5 September 28, 2001
PHASE II Task 3 Deliverable implementing software updates, and providing a forum to address internal issues regarding data and reports. VIII. Impact on Constituents The e-business querying and reporting functions should have a highly positive impact on most NEDSS constituents. Through improved early detection and management, public health programs for the State of Maine could be more effective and efficient in protecting and treating the citizens of Maine. Furthermore, in conjunction with the web browser improvements for data reporting, the e-business functions can lead to improved management and treatment programs for both providers and public health agencies. The one constituent group that may experience a modest negative impact could be the Maine Bureau of Health, who is responsible for data security, collection, verification, storage, and all system maintenance, including the necessary data query and report generator software. These are sensitive data, and access and reporting functions will require strict monitoring procedures from BOH. Nevertheless, it is anticipated that there would be, at most, only a modest increase in BOH workload stemming from these e-business functions. This could be more than offset by the human resource savings should other BOH datasets be incorporated into NEDSS for the collection, cleaning, storage and/or reporting of data. IX. Creative and Cognitive Design It is expected that there would be no creative or cognitive design issues regarding the e-business functions. The necessary NEDSS architecture will have already been created, and the various constituents will create the subsequent reports generated through the e-business functions online. The one caveat involves any projected increases in the numbers of users and the volume of queries and reports generated, especially with the addition of other public health datasets. Should the volume exceed the current system capacity, new system architecture (and programming) may need to be configured to meet the demand for the e-business functions. X. High Level Architecture As noted above, existing system architecture planned for the base system should be sufficient to handle short-term projected e-business query and report generating demand. The system supports web browser-based data entry and retrieval, as well as the additional query and report generating functions, although subsequent user activity could require higher level architecture to improve data access, processing speed, and information dissemination. PHRG 5 of 5 September 28, 2001
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