1. Introduction By Attendees and
Opening Statements.
A. Review
of summary from December 5, 2000 TAG meeting. Note: TAG summaries
are available on the Web at: http://www.avss.ucsb.edu/tag.htm
2. Version 4.10 Update.
A. Since
the interim update, Version 4.9B, incorporated many of the updates
that would have ordinarily been contained in the annual update,
there was a more relaxed schedule in implementing Version 4.10.
Most of the updates were performed by modem. All LRDs except for
San Francisco have been updated.
B. The
most important change in Version 4.10 is that a Hospital Birth
Record must be flagged as SENT using LIST TO BE SENT TO HEALTH
DEPARTMENT before it can be registered as a Birth Certificate.
Another important change is the re-ordering of the GENERATE FILE
suboptions under the BIRTH CERTIFICATE option. The Release Notes
are posted on the Web at http://www.avss.ucsb.edu/release.htm
3. Entering Death Certificates Into AVSS/Electronic Death Registration
A. All
County Letter 01-04 was reviewed by Michael Rodrian. The letter
communicates the concept of using AVSS to address the current
backlog of death certificates that have "pending" for
the cause of death. The Office of Vital Records will reimburse
LRDs that adopt this procedure at rate of $1.00 per AVSS electronic
death record.
B. Jessica
McCarroll explained the new procedure using a flowchart. It involves
entering a minimum number of death certificate fields into AVSS,
entering a "-1" into the UCOD field for the pending
cause of death, making copies of pending death certificates and
forwarding them to county recorders, holding the original certificates
until cause of death is determined or up to 60 days, and then
entering a "0" for UCOD. Blue "target" copies
of certificates with pending causes of death are to be included
in transmittals.
C. LRDs
electing to participate should call Alan Oppenheim (916-324-1100)
or Jessica McCarroll (916-322-5179). The reimbursement of $1.00
per AVSS death record will be in effect until June 30, 2002 and
may be extended.
4. AVSS Modification Requests (AMRs): Review and Discussion.
01-021: Some LRDs found the Version 4.10 requirement that
Hospital Birth Record must be flagged as SENT using LIST TO BE
SENT TO HEALTH DEPARTMENT to be time consuming. A suggestion
was made that it not apply to out-of-hospital births. This would
save time at LRDs having high volume of home birth registrations,
but would compromise data quality for non-hospital births registered
by hospitals. After some discussion it was decided not to make
the change to AVSS.
01-041: One LRD uses a non-AVSS system to collect death certificate
data. OVR suggested that it might be useful to develop an import
utility for AVSS. Given the ongoing problems with importing birth
data from foreign systems, the effort involved, and the likelihood
that only one LRD would participate, there was a consensus not
to develop this capability.
01-043: The new procedure discussed in Item 3 above for processing
death certificates with pending causes of death could be made
more efficient if AVSS could produce a transmittal listing of
pending certificates including LFN, name, and date of registration.
This would not be difficult to program since it could make use
of the LIST TO BE SENT suboption under the HOSPITAL BIRTH RECORD
system option. There was a consensus to add this capability.
5. AVSS Automated Birth-Death Matching.
A. MCH
is providing funding to improve AVSS birth-infant death matching
and to possibly incorporate it into the ongoing OVR operations.
Matching is preferably performed at the state level since family
mobility can result in a change in residence during the first
year of the infant's life and consequently infant death certificates
may not be reallocated back to the LRD of birth. The AVSS Project
is also looking into the possibility of merging cause of death
information as obtained from OVR into the AVSS database at OVR.
It should be possible to produce a linked birth-infant death cohort
files soon, and this could be distributed to LRDs. If interested,
e-mail the AVSS project.
6. The Future Of AVSS.
A. Computer
systems at a number of older AVSS installations are beginning
to show signs of age. The AVSS Project has developed the means
to refurbish these systems with new disk drives/controllers and
improved methods of database backup using removable hard disks.
A total of nine LRDs have been updated by this means with the
resultant systems more reliable and running 5-10 times faster.
LRDs having hardware that is showing signs of malfunction or poor
performance should contact the AVSS Project for assistance.
B. Ron
Williams reported on the progress to modernize the AVSS computer
architecture using the Internet as proposed a year ago. Based
on Windows 2000, AVSS/NET uses SSH (Secure Shell) encryption technology
to establish secure Telnet sessions to a central server. This
requires two servers at the central site: an encryption (SSH)
server connected through the Internet to a user workstation running
a terminal emulation program, called SecureCRT, and an AVSS/NT
server connected to the SSH server in a secure environment. AVSS
can thus migrate to this modern computer platform and appears
functionally identical to the present DOS-based system. The AVSS
Project established a new AVSS/NET facility at UCSB in early 2001
with redundant severs (two SSH and two AVSS) and broad band Internet
access. In addition to using encryption, AVSS/NET requires two
users names and two passwords to log in, so security is enhanced
compared to the present system that requires only one password.
Merced County was converted from its DOS-based AVSS to AVSS/NET
on May 7, 2001. Sue Ollis of Merced County reported that the new
system is faster and more convenient since it runs on the Windows
platform. In general the Internet has been responsive but there
are times when it is slow. Merced County is working on improving
its Internet access. The AVSS/NET server has been reliable, operating
24/7, but there was one incident of downtime lasting four hours.
C. Pam
Isaac asked when AVSS/NET would be available to other LRDs. Ron
Williams responded that at least six months and possibly a year
of testing would be necessary. Although most of the functionality
has been developed, there is still a need to establish a means
for the secure transfer of ASCII files from the UCSB servers to
LRDs. Additionally, AVSS/NET is considerably more costly in terms
of software licenses than is DOS-based AVSS.
7. Confidential Morbidity Report (Discussion Led By Mark Starr:
See attached CMR Topics).
A. Peaches
Grant of San Diego and Mark Starr of DHS organized the 2nd Annual
Morbidity Meeting to discuss a variety of CMR topics, with special
emphasis on AVSS, on June 5, 2001, to coincide with this AVSS
TAG meeting. The agenda for this meeting was distributed. There
was a good turnout and a similar meeting is likely to be scheduled
next year. The potential impact of HIPAA in the areas of privacy/confidentiality,
security, and data content was briefly discussed.
B. Mark
Starr can be contacted at mstarr1@dhs.ca.gov
8. Census Tracting.
A. Alameda
County reported that the 2000 Census has added more tracts, which
may pose a problem of consistency for 2000-2001 AVSS data that
has already been tracted using the 1990 street index files. The
solution is to install the updated AVSS Census Tract Street Index
file (in cooperation with D-M Information Systems), delete the
census tract field for the appropriate AVSS forms, then re-tract
the 2000 and later records. Those LRDs interested in following
this procedure should contact the AVSS Help Desk at 916-324-8232.
9. AVSS Technical Assistance.
A. A
draft letter to LRDs requesting FY 01-02 contributions of $1,500
plus $500 per added AVSS site was presented. There was a consensus
that the letter was appropriate and should be mailed.
B. In
order to improve data quality and enhance registration efficiency,
OVR and the AVSS Project are encouraging all LRDs to use AVSS
to print local file numbers and their associated bar codes. The
HP 4100 is the recommended printer. Contact the AVSS Project if
you are not using bar codes and are interested in doing so.
Acknowledgment: This summary is based on notes taken by Emily
Lehman and written by Ronald Williams.
1. SSS Update
-- 5-year CD Report (1994-1998)
- currently in DHS report approval process;
1999-2000 CD Report in progress
-- Case report forms now available in PDF format (view/print only;
many now "filllable") on our web-site
(above) - Click on "Publications", then scroll to FORMS
section and click on link;
Username: cdforms, Password: broadstreet
-- Electronic laboratory-based reporting (ELR): California Electronic
Laboratory disease Alert and Reporting (CELDAR) system - in-house
demonstration project w/ MDL & ITSD - now operational; modest
increases in grant funding from CDC for Bioterrorism Preparedness
and NEDSS (see below) - to pilot with LHD labs, HMO lab, State
veterinary lab, commercial lab
[Reminder: Laboratory and syndromic electronic reporting
pilot w/ No Cal Kaiser (6 months) was completed in early 2000
-- web-site still available.
URL: http://www.dhs.ca.gov/phip, Username: PHIP, Password: broadstreet;
NOTE: Provisional Northern California Kaiser Lab data only.
Prototype for web-based data access in future -- CHECK IT OUT!!]
-- National Electronic Disease Surveillance System (NEDSS): Grant-funded
(CDC)
project to use data and arhcitecture standards in surveillance
systems --> interoperable surveillance systems (NEDSS = "system
of systems").
Assessment and Planning completed; Element Development ("Integrated
Data Repository" started). More NEDSS info: http://www.cdc.gov/od/hissb
-- Proposed pilot of provider-based internet PH reporting
(w/ Lawrence Livermore
National Labs and DHS Health Info. & Strategic Planning, Calif.
HealthCare Foundation funding): Pilot proposal for CD reporting
completed by LLNL, but still under review by DHS, CHCF. Design
includes integration with AVSS, HMOs, etc.
2. "Old Business"
-- CMR form and Title 17 (sec. 2500, 2505, etc.) regulations
revisions: Emergency regulation changes close to approval; Full
reg changes (and CMR revisions) to begin soon (comments still
welcome)
-- AVSS-CMR: Deletions ("~DELETE" for DISEASE) - use
in place of "SCRATCH"
Pending Morbidity Report (DMR) --- "case management"
and "early warning" tool
AVSS foreign data import - ready for pilot
CMR/Reporting Manual updates/additions - send suggestions/ideas
Still pending: Revisions of disease list (re-working),
subtype list, and
download (ASCII) file layout; CMR Users' Group
CMR User's group --- 2nd Annual Morbidity Meeting yesterday (June
5, 2001).
Updated July 27, 2001 by RL Williams
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