From kal0303@doh.wa.gov Fri Feb 12 11:15:10 1999 Received: from mxu1.u.washington.edu (mxu1.u.washington.edu [140.142.32.8]) by lists.u.washington.edu (8.9.2+UW99.01/8.9.2+UW99.01) with ESMTP id LAA22862 for ; Fri, 12 Feb 1999 11:15:09 -0800 Received: from smtp.doh.wa.gov (hub.doh.wa.gov [192.230.1.5]) by mxu1.u.washington.edu (8.9.3+UW99.02/8.9.3+UW99.01) with SMTP id LAA00548 for ; Fri, 12 Feb 1999 11:14:54 -0800 Received: from Connect2 Message Router by smtp.doh.wa.gov via Connect2-SMTP 4.00; Fri, 12 Feb 99 11:17:08 -0800 Message-ID: <51DD774A014C3700@smtp.doh.wa.gov> Date: Fri, 12 Feb 99 11:15:15 -0800 From: "Lukens-Bull, Katryne A." Sender: "Lukens-Bull, Katryne A." To: ph-assess@u.washington.edu Subject: AOG Rounds X-mailer: Connect2-SMTP 4.00 MHS to SMTP Gateway As promised last month, here are the AOG rounds for the assessment listserv. Let me or the contact person know if you have comments or questions. Thanks Office of the Secretary/Local Health (Katryne Lukens Bull 360-236-4063) Vista: The new beta version of Vista is out and about being tested. The release of the official new version should be ready soon. All of the 97 data is loaded but we are still debating the best way to handle the denominator problem. Sharon Estee is working with others to figure out the best approach to solve this dilemma. Currently the denominators in Vista up to 1996 are okay to use. 1997 denominators have not been controlled to the new OFM population numbers - Sharon will be explaining more about denominator data at the regional assessment meetings and at a session for DOH staff on Feb 26th in building 8 conference room from 10-12. There will also be a Vista demo after this presentation from 1-3pm in the same room. We are taking steps to provide better TA for DOH users of Vista by trying to host some Vista demo/discussion sessions everyone month or two. Let me know if anyone has other ideas for supporting Vista internally. As a side note to the denominator issue - we had an interesting inquiry into if anyone was documenting the apparent migration of populations due to welfare reform. Folks locally have anecdotal informaiton about decreases in rural school enrollment and because, they hypothesize, people with kids who need to do welfare to work are moving to urban areas where there are more jobs. The urban areas are seeing people move onto their fringes where housing is cheaper. Sharon Estee is check with other agencies to see if anyone is working on quantifying these reports but no luck yet. Quality Child Care Report: Skagit County recently released a report on Quality Child Care which is based on a number of surveys they did with providers, child care workers, and other stakeholders. It is a very well done report. For more informaiton contact Alex Von Cube or Jennifer Sass at Skagit Co. Access trainings/Software: There are a number of programs currently preparing ACCESS databases for local health jurisdictions to use to obtain access to their data. These include EH - SADIE which gives local health access to drinking water information and Child Death Review plus Thurston County has also created an ACCESS based communicable disease system. If you are aware of other ACCESS based system please let me know. These systems create a need at the local level for training in ACCESS. Each program is planning to offer training but we would like to coordinate efforts (not have them on the same days, etc). Joint Conference: Because of the overwhelming demand for ACCESS we are hoping to organize a training on this software for the joint conference. We would also like to use examples of successful database applications. Second, there has been an idea put onto the table by Jim Kreiger (SKCDPH) to hold a 1-2 day conference after the Joint Conference where local health and others from the surrounding states could meet and do a show and tell of what each other is doing. We are still working on whether this would be a good idea/work so we should have a better idea next month. Notifiable Conditions: Phil Dunham and I are beginning a project (For Jac Davies and Greg Smith) to standardize the data elements that all the notifiable conditions have in common (like name, DOB, address, etc) including definition, coding, and format for the database. This process is just beginning so there will be more details coming. Regional Assessment Meetings: Meetings are scheduled for Feb 17 (Mt Vernon), 18 (Olympia) and March 3 (Moses Lake). DOH staff who would like to attend should let me know so I can make sure the room is large enough. We will be doing local health rounds in the morning, Sharon will then talk about the denominator data and then Vicki Sussman will talk about Child Death Review. ************************************************************************** ***** Here are Environmental Health Program Rounds (Denise Laflamme: (360) 236-3174) Hazardous Substances Emergency Events Surveillance (HSEES). Analyzing HSEES data for 1993-1997 and preparing 5 year report for the Agency for Toxic Substances and Disease Registry (ATSDR), who funds HSEES. Report will be provided to local health departments and local emergency management organizations. Pesticide Incident Reporting and Tracking (PIRT). Legislative Summary on 1997 incident data prepared. Will be preparing annual PIRT report on 1997 data later this year. ************************************************************************** ***** EHSPHL Rounds (Jac Davies 206-361-4883 and Sharon Estee360- 236-4321 and Vicki Hohner 360-236-4211) Office of the Assistant Secretary EHSPHL is mobilizing to respond to the CDC's bioterrorism RFA. The agency response is being managed by Janice Englehart in Environmental Health. EHSPHL will be involved in writing the sections on Epidemiology and Surveillance Capacity and Public Health Laboratory Capacity. The Antibiotic Resistance Project is moving forward with the development of educational programs for clinicians. DOH is also participating on a workgroup led by the Association of Washington Health Plans to adopt specific therapeutic guidelines for judicious antibiotic use in treating otitis media and other common childhood infections. Jac Davies and Greg Smith have been working on a revised version of the Surveillance Initiative, to ensure that the Initiative contains current agency activities. They are presenting the updated Initiative to the ASG and local health officers, along with progress reports on the different activities contained in the Initiative. Major on-going assessment activities in Non-Infectious Conditions Epi: * Youth Risk Assessment Database: no activity this month; plan to update "easy" data elements, possibly develop county level-estimates and survey Networks and LHJs about usefulness of database * EpiQMS: continued development * Lead Prevalence Survey: will draw sample for birth certificate follow back in February. * SeaTac investigation (with EHP and SKCDPH): analysis of cancer around airport, literature review; review of air quality data; public report due Feb 18th. * Whatcom County childhood leukemia investigation (with Whatcom County HD): Draft report shared with survey participants; awaiting revisions from local health and further input from external review. *Selection of core indicators (federal level HP2010): NCHS meeting on "leading health indicators" 1/21-22; CSTE consultation through February. * Analysis of hospitalizations at military and veterans' hospitals (with CHARS, UW): MPH practicum students interviewing LHJ assessment staff in six counties and information systems staff at eight hospitals; HAWG presentation planned for 2/23. * Asthma surveillance data evaluation [with American Lung Association (ALAW)]: data users survey Planning Committee (composed of 4 LHJ assessment staff, plus one each from L&I, UW, ALAW, and DOH) developing list of survey recipients; selection of contractor for mail-back survey and key informant interviews planned for February; selection of counties for medical record audit planned for February; solicitation of sentinel physicians panel for record linkage planned for February and March. * Analysis of PANT data (with CWP): Final data set preparation including data quality checks and calculation of summary and risk factor variables. Descriptive analysis of physical activity questions in process during Feb. * Review of medical records for patients hospitalized for acute pesticide exposure (with OTS): Nearly all Western Washington records reviewed; planning for review of Eastern Washington records in Feb/March. * Participation in discussions for one statewide, school-based survey every two years New Activities in January: *Analysis of the domestic violence question on the 1998 BFRSS (with CFH and HSQA). Center for Health Statistics At the annual NAHDO conference, discussions were held on the development of a Public Health Consortium for Health Data Standards. NAHDO is facilitating the process of bringing together a variety of public health and health services research organizations to represent public health interests in the HIPAA implementation and other data standards setting processes. EHSPHL will be tracking the activities of this consortium, to ensure that Washington's standard setting efforts are consistent. Further information on the NAHDO effort can be found at WWW.LEWINCOM/HIPAA. Center for Health Statistics Dan Rubin and Oscar Cerda have requested assistance in examining health disparities among racial/ethnic groups in Washington State as shown in available publications. Staff from the Center will assist as needed in this process. The 1999 BRFSS questionnaire opened in the field on January 5, 1999. Interviewers reviewed the 1999 survey and participated in training for dealing with upset respondents. CHS staff are meeting with hospital staff statewide to discuss the procedures in how the birth data is collected at each hospital, data profiles of how their hospital compares to the state on key variables, challenges in gathering good data and how they can improve the collection of the data. Staff attending the meetings are birth clerks (generally from Medical Records), head nurses, some nurses, and occasionally a social worker. The meetings are bringing the birth center staff and medical records staff together to bridge a common communication gap between this group. For this purpose the meetings have proven to be very successful. Sharon Estee is working with OFM to get 1997 sub-county population estimates for VISTA. ************************************************************************** ************************* Office of the Secretary Rounds (Dan Rubin 360-236-4023) 1. On 2/5 ASG will begin discussing workplans for the activities the 1998 PHIP committed DOH and local health agencies to carry out: Establish core indicators, Set minimum standards for public health system and Address health care access barriers. Joan Brewster from OS will provide a starting point. 2. DOH is developing a response to constituents' and legislators' interest in health disparities in racial and ethnic minority groups. Dan Rubin, Oscar Cerda, and Joan Brewster are working together to coordinate. Part of this will be a quick thought process to identify a short list of stand-out issues based on the formal assessment work we've done. I will talk about this further at AOG Tuesday. (See related mention in EHSPHL rounds/additions from CHS.) 3. As noted in EHSPHL rounds, DOH has begun work to respond to the CDC Bioterrorism RFA. Dan Rubin of OS is supporting Elizabeth Ward (Executive sponsor) and Janice Englehart of EHP (project manager for the proposal) in overall coordination of this effort. ************************************************************************** ************************* Management Services - Office of Informaiton Resource Management (Ron Seymour: (360) 236-4425) Though these are not necessarily assessment related activities they may be of interest. 1. DOH will be replacing the DaVinci email and CaLANdar systems with Microsoft Exchange loosely scheduled for this summer. This will affect most everyone in the agency to some extent. OIRM (Dean Galvez) is taking the lead on this effort. 2. The Information Resource Directory application is available on the DOH Intranet site. We will be demonstrating this for the AOG, I believe next month. There is a lot of work to do around the data that it contains. Part of our demonstration will be to get feedback from you'all about ideas for other data that you would like to see. 3. We are being required by DIS and OFM to develop a portfolio for information technology within DOH. The content of this document will directly affect our ability to get funding for IT type projects. Basically we are being told if the projects or initiatives is not in the portfolio, funding will not be approved. I believe this is actually a good thing for DOH to have. It is do to DIS in June. It will be a web based document that everyone can look at. 4. With the launch of the new DOH web site in January we have received over 567,000 hits in January. In December there were 167,000. A hit is counted each time someone comes to our home page and then they click their mouse to surf around. We had 26,101 visitors to our web page in December 1998 and 35,832 in January. Which tells us that we did get a significant number of visitors and they spent a lot more time surfing our pages. These statistic are available on the DOH Web site, under "Health Data". They are pretty interesting to look at. 5. With OIRM is working with CHS and DIS on promoting the availability of ordering certified vital records via the Internet. These include:birth, death, marriage and divorce. ************************************************************************** ************************* Health Services Quality and Assurance (HSQA) Steve Bowman (360) 705-6730 Very brief rounds --- The Trauma Registry is awaiting its Y2K software upgrade for the hospital and prehospital registries. Reporting compliance for hospitals continues to improve, and all but one hospital is now using the DOH-provided COLLECTOR software. Providers currently submit encrypted data on disk or via email, and a new file transfer protocol has been established to allow electronic transfer of data via the internet. All designated trauma services were sent registry survey to assess their satisfaction with our software and technical support, and to determine their training and service needs for the future. We received a response rate of more than 75%, and the surveys are currently being compiled and analyzed. Office of Community and Rural Health(Vince Schueler: 360-705-6767) -- Federal Definitions of Metropolitan/Non-metropolitan and Urban/Rural. OMB has released an initial request for comment on developing new definitions for metro and non-metropolitan areas (Federal Register 12/21/98). These definitions may have a significant impact on where Federal resources targeted to "rural" areas may go (e.g. Critical Access Hospitals). We are preparing comment for a 2/12/99 deadline. This is the first act of what is expected to be a long drama. - Health Service Area (HSA) boundaries. The Health Workforce Center at the University of Washington has updated the zip code definitions for the Health Service Areas developed as part of the the Health Workforce Analysis (formerly known as HPRP). I have the file or you can contact Eric Larson at the Workforce Center. They are also contemplating realigning HSA boundaries in urban areas to fit a more consistent metric. HSAs in urban areas were initially developed based on individual LHJ recommendations and don't reflect a consistent approach. If there are any strong concerns/comments from HSA users pass them on to me an I will forward them. - Health Care provider surveys/shortage area designations. We are currently working on provider surveys/shortage area designations in the following areas: Grays Harbor County (Primary Care), Clark County (Primary Care), Spokane County (Primary Care and Dental), Western Snohomish County (Primary Care and Dental), Kittitas County (Primary Care), Stevens County (Primary Care), Ferry County (Primary Care), Jefferson County (Dental) ************************************************************************** ************************* Rounds from Community Wellness & Prevention (CWP): (Mary LeMier 360-236-3693) A draft report on Tobacco and Health has been sent out for review and comment. We hope to get the final report distributed by the end of February. The new CIMS system is almost 1/2 implemented, in terms of locals trained, clinics up and running, and caseload now in CIMS. CIMS is the first of the department's mission-critical systems to pass Y2K testing. This month's EPI trends includes an article about the Breast and Cervical Health Program. We submitted an article on adult smoking prevalence for next month's EPI trends. -------------------------------------------------------------------------- Rounds from Maternal and Child Health (MCH): ( Mary Foley at 236-3530) We've completed the first draft of the Child Death Review Data Collection Form and hope to finalize it by the end of the month. PRAMS - We have begun working with CDC on questionnaire revision of core questions. Core questions are scheduled to be revised for the year 2000. An evaluation of state added questions is also being conducted in preparation for revising the core questions, as well as to begin planning for any changes to the state added questions. 1997 PRAMS data have been weighted by CDC and analytic datasets constructed. MCH Block Grant Needs Assessment - We are assembling data on child and adolescent health (including immunizations) mortality, morbidity and risk/protective indicators for a prioritization retreat to be held in late April. The retreat will identify 7-10 priority issues for child and adolescent health, as well as point out needs for future data collection and analysis. The April retreat is part of a broader process to identify 7-10 statewide MCH priorities and to develop a 5 year plan for the MCH block grant . Birth Defects - The National Birth Defects Prevention Network met in January and we presented a poster on Washington's efforts to enhance our current surveillance system. -------------------------------------------------------------------------- Rounds from Infectious Disease & Reproductive Health (IDRH) (Scott LaMontagne 360-236-3459) The 1998 STD Annual Report will be printed next week for distribution to over 1000 providers by month's end. Scott just completed an analysis for the Washington State Chlamydia Project modeling 16 different screening strategies for criteria to yield the most positives from the least number of screened women. Washington will propose to the Region X Advisory Committee to modify the current criteria to reflect changes in prevalence, affected populations, and advanced testing assays. Maria Courogen is completing the 1998 WA State HIV/AIDS Epidemiology Profile, which will be published/distributed shortly. Copies can be obtained from the Office of HIV Prevention and Education Services by calling 236-3434 after March 1. Todd Rime has completed two out of three parts of the evaluation of the Family Planning data system. Recommendations for changes in the way data are collected, transmitted, interpreted, and stored are currently under consideration by a Region X data committee, based on a review of 1996 Family Planning data and a site visit to the program's database contractor in Waco, TX. The last part of the evaluation is a comprehensive qualitative analysis of the interviews conducted with family planning clinic staff at various sites across WA. This should be completed within the next month and a half. Re. HIV reporting: The King County Board of Health passed a resolution proposing that names of HIV-infected individuals be converted to a soundex-based code after 90 days. DOH policy-makers are reviewing this proposal, which will likely be discussed at the March meeting of the state Board of Health. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Katryne Lukens Bull, MPH, CHES Phone: (360) 236-4063 Washington State Department of Health Fax: (360) 586-7424 Office of Planning Pager: (360) 971-0586 1112 SE Quince St. E-mail: kal0303@doh.wa.gov PO Box 47890 Olympia, Wa 98504-7890 .