Attachment H - WV Data Bridge - Informational Guide.pdf

Current Data Systems Source: Text content provided by: WV MIS

● National Electronic Disease Surveillance System Based System (NBS) o Four databases:

▪ Operational Data Store (ODSE)

▪ Reporting Database (RDB)

▪ System Reference Tables (SRT)

▪ Message Out (MSGOUTE)

● WV Statewide Immunization Information System (SIIS) o Vaccination event registry

● WV Outbreak Reporting System (WVORS) o Developed/planned for greater integration with NBS o With Master Patient Index (MPI) this could ripple out into investigating possible extent of community spread outbreaks

● Wastewater surveillance o Ad hoc downloads of wastewater surveillance data are loaded which cover COVID, influenza, and historic norovirus surveillance

● Infection Control Assessment and Response (ICAR) o Bridge adjacent, developed to interface with WV Outbreak Reporting System (WVORS) but was closed off from that based on program concerns with protecting facilities from potential punitive action through FOIA of the data

Attachment H

● WV Health Information Network (WVHIN) o Contributes race and ethnicity data for enhancing COVID lab, vaccine data sets o Respiratory virus and COVID hospitalization data

● Universal billing data o Medical billing data that is legislatively mandated for collection and currently is stored on the WV Data Bridge, but doesn’t yet have clear use rules in place

● VitalChek o Birth and death data o The death data is already prepared and used for the limited use case of providing COVID death data for the Respiratory Virus Dashboard

● Electronic case records (eCR) o Electronic case records are expected to commence integration into the WV Data Bridge shortly. The database has been configured to accommodate this data, and the Rhapsody routes required for facilitating the data flow are currently pending implementation.

Success Stories

Vaccine Breakthrough Reporting

During the COVID pandemic (2020-2022), analyzing vaccine breakthrough events required comparing data from the immunization registry, NBS COVID lab data, and ChexOut COVID case data. Daily linkages and verification of data had to be conducted across thousands of records from all three systems.

A SQL script was written on the WV Data Bridge to provide daily updates to the COVID dashboard. This information appeared in daily reports for the public and public health partners. Additionally, the script provided data for the monthly CDC assessments while emphasizing the reduction of false negatives or false positives.

Demonstrated the capacity to integrate multiple data sources into a unified key output.

This integration enabled epidemiological staff to concentrate on more critical inventions and investigative tasks. Furthermore, it continued to operate, contributing to a dataset that can be analyzed retrospectively in the future.

COVID Migrations

During the COVID-19 pandemic, West Virginia shifted from using NBS (NEDSS-Based System) to a combination of NBS, contact tracing and clinical management software (ChexOut) to manage COVID-19 investigations and contract tracing. Positive lab results were extracted at two-hour intervals between 6 AM and 6 PM from NBS and sent to an SFTP server for ChexOut to import daily. However, the ChexOut software lacked a way to transfer case records back to NBS, did not support sending NNDSS messages, and was unable to generate reports.

In 2022, following the suspension of the pandemic emergency declaration, the MIS team collaborated with Inductive Health to initiate preparations for the transition from the hybrid model back to NBS. This work involved checking COVID-19 investigation pages to ensure data acceptance, following the latest COVID-19 message mapping guide, and matching data formats for the NBS system. Additionally, it was essential to organize the data to facilitate the transfer of active ChexOut cases from the preceding 90 days as well as on the designated cutover day.

During the transition from ChexOut to NBS, the WV Data Bridge minimized complications and ensured users could access reports and datasets without interruption. It also plays a critical role in integrating and automating data related to immunization information, outbreak data, vital statistics on infectious diseases, and additional datasets from external partners. This process significantly streamlined data transfer between different end systems, as the WV Data Bridge efficiently managed compatibility with diverse formats, standards, and linkages. Furthermore, it enhanced the flexibility of process configuration and troubleshooting.

Respiratory Virus Dashboard

Prior to October 2023, flu surveillance summary data and case investigation records were manually compiled and updated, often containing contradictory information.

Matching and joining records across various systems could take hours.

The implementation of WV Data Bridge has facilitated the automation of various processes, resulting in freeing up hours of staff time each week and a reduction in the introduction of errors. This enhancement in efficiency has allowed staff to concentrate on more strategic initiatives, thereby contributing to overall operational effectiveness.

This exemplified the ability to seamlessly automate multiple data flows, simplify processes, and ensure a more reliable public facing output. The modularity of the design allows for data systems to be easily updated or repurposed with minimal change to the overall platform (COVID surveillance dashboard —> Respiratory Virus Dashboard).

Hepatitis C Point of Care Testing

In 2024, the rapid point of care testing for hepatitis C infection introduced a challenge for public health reporting. The tests were conducted in physician offices at a lab facility that would conventionally report the data to OEPS.

An alternative method of collection was created in the form of an electronic survey to capture the testing results and necessary demographics on the patient. However, the results would still need to be downloaded, and manually entered for follow up and case investigation/management. This could result in seven or more hours a week of additional staff time checking and downloading new labs from SelectSurvey and manually entering the results into WVEDSS.

Utilizing the WV Data Bridge, OEPS was able to automate the querying of new lab results from SelectSurvey, read them into the WV Data Bridge, format the results as a CSV file and upload the file to WVEDSS via Inductive Health’s SFTP. The results are then pulled by Rhapsody for ELR and processed as an ELR into WVEDSS without any OEPS staff intervention. A report is then generated by the Bridge that links lab records back to the original records and identifies which lab results have successfully processed and which results are still pending processing

This streamlined work and data flows within the OEPS, linked vital statistical records to WVEDSS lab reports to help identify perinatal HCV infections, and can be applied to other initiatives to expedite ingestion/utilization of lab tests that do not conform to conventional reporting mechanisms.