Electronic Disease Notification (EDN) · – Sex – Place of Birth ... – Give the EDN Helpdesk staff the alien number, port of arrival, and arrival date. – The Helpdesk staff

National Center for Emerging and Zoonotic Infectious DiseasesDivision of Global Migration and Quarantine

Lana Jones

Electronic Disease Notification (EDN)


Overview

•Background•Notification•Documents and data

EDN Background• Immigrants and refugees required to

undergo TB screening/medical examinations before entering US

• Over 670 panel physicians (overseas physicians), designated by the US Department of State, perform these screenings

• 450,000 new immigrants and refugees arrive in the US each year with their medical examination documentation

• These medical documents—for all refugees and only immigrants with medical conditions such as TB—are collected at one of CDC quarantine stations

EDN Background• Refugees and immigrants with culture or smear positive TB ‐ ‐

are treated prior to arrival in the US• After arrival, CDC’s Electronic Disease Notification system

(EDN) notifies nearly 500 TB and Refugee Health coordinators in health departments of the results of overseas medical examinations

• Heath departments can enter results of post arrival TB ‐evaluations into EDN (TB follow up worksheet)‐

• In October 2008, EDN completely replaced the previous paper based system‐

EDN Data Entry Center• Located outside of Atlanta (Lawrenceville, GA)

• 11 data entry clerks and 1 manager (Nekeia Gray)

• Paperwork collected at Quarantine stations is sent directly to the EDN Data Entry Center for entry into EDN

• Enters information from scanned medical documents

• EDN helpdesk is housed at the Data Entry Center (hours 6:00 2:30 EST)‐

Broad Partnerships• Division of TB Elimination (CDC)• State and local health departments– Refugee Health Coordinators– TB Controllers

• Federal partners– Department of State– Department of Homeland Security

• International Organization for Migration (IOM)• VOLAGs/Resettlement Agencies

EDN Information Flow

EDN User Community• More than 500 active users• Health Departments in all 50 States (state,

county and local) & Washington, D.C.–264 jurisdictions

• TB Controllers (199)• TB/Refugee Health Coordinators (176)• Refugee Health Coordinators (110)

EDN Jurisdictions

Overall EDN TB Follow up Reporting‐

• Excludes all U.S. territories• 2011 reporting year only includes quarters 1 and 2

TB follow up rates were greater in states where local and city ‐health departments had access to EDN than those who did not

Notification Data for 2011• US Total 73,493‐• Average time from arrival to notification 5 days‐• FY 2010 average time was 11 days‐

• Immigrants 18,412‐• Average time from arrival to notification 5 days‐• FY 2010 average time was 13 days‐

• Refugees 51,097‐• Average time from arrival to notification 5 days‐• FY 2010 average time was 11 days‐

Days from Arrival to Notification2009 2011‐

0

5

10

15

20

25

30

35

40

45

2009 2010 2011

Median Days Total‐Median Days Immigrant‐Median Days Refugee‐

Top 5 Birth Countries for US bound Immigrants ‐and Refugees 2011‐

• Immigrants– Philippines– Mexico– China– Dominican Republic– India

• Refugees– Cuba– Myanmar– Bhutan– Iraq– Nepal

Top 10 Birth Countries of US bound Immigrants ‐and Refugees 2011‐

Recent EDN Improvements • Easier access to EDN

– System upgrade—Microsoft SQL server upgraded to alleviate stalls

– Single password access with 1 year expiration• Users no longer required two passwords to access the EDN

web interface. The 30 day password expiration was ‐removed.

• System activity reports– Percentage of TB worksheets started– Sub migrations to and from‐

Recent EDN Improvements cont.• Alien information page now includes some Pre

Departure Medical Form (PDMS) data– Anti Malarial and Anti Helminthic treatment‐ ‐– Pre Departure vaccination information

• Added Hansen’s Disease module– Federal Hansen’s disease users will receive

notifications of refugee/immigrants diagnosed with Hansen’s disease.

EDN Notification

Notification

• Every night at 9pm EST• From [email protected] (also the HelpDesk email

address)• Sent to user reported email address‐• Could be yours or a shared box

• Generic email; no identifying content included

EDN login sdn.cdc.gov Contact EDN Help Desk to gain access to a digital

certificate and challenge phrase

EDN Basics

EDN home screen Admin Tasks

Update user profile

EDN Workflow

Help Contacts EDN guides

EDN Workflow

• The EDN Workflow is a menu of the functions you can choose in the EDN system to complete your health department assignment.

• Most of your work in EDN will be accomplished with the functions in the EDN Workflow.

Alien List• View a list of newly arrived refugees and immigrants.• Retrieve Alien Information for a specific refugee or

immigrant. • View the medical history and overseas examination for

an alien in your jurisdiction. • View the scanned documents for an alien in your

jurisdiction. • Update the address for an alien in your jurisdiction.• Access and print a TB Follow Up Worksheet for a specific ‐

alien. • Obtain an address history for a specific refugee or

immigrant. • Check the status of medical follow up for a specific alien. ‐• Export data about an alien to an Acrobat or Excel format.

Alien List cont. Sortable on all columns “New Alien” checkbox

Removed when you access alien Can manually re check‐

Alien Search All aliens – even in other jurisdictions Default search is for the past year, but can expand

over life of system• The alien number is a randomly assigned nine digit ‐

identifier.• If you encounter an alien number with only seven

digits or eight digits, add one or two zeros (00) at the beginning of the number (e.g., 001 234 987).‐ ‐

• The File Number generally contains two letters and six randomly assigned digits. A File Number denotes a family of refugees.

• You can enter a partial name if you do know the spelling of the entire name.

• The “Start Date” must be early enough to include the date the alien arrived in the United States. The EDN system includes aliens who have arrived in the past year and archives those who arrived more than 1 year ago.

When to use Alien Search• Find an alien’s records quickly without

looking through the Alien List.• Find family members of an alien. • Search for an alien in other jurisdictions.• Find records for an alien who has moved

into your jurisdiction from another U.S. jurisdiction.

• Find an alien who has moved from your jurisdiction to another U.S. jurisdiction without notice.

• Check the status of an alien’s medical follow up. ‐

Individual Alien functions• Click on an alien number from

Alien List or Alien Search• The Alien Information screen

for a refugee provides you with:– Name – Arrival date– Quarantine Station– Voluntary agency (VOLAG)– Contact information for sponsor(s) – Date of birth– Sex– Place of Birth – Identifying information for all aliens

with the same File Number– Demographics– Pre Departure Medical Screening ‐

(includes pre departure vaccinations, ‐anti parasitic and anti helminthic treatments)

Individual Alien functions cont.

• To save/export Alien Information – Click on the save/export icon. – Click on Acrobat or Excel format.– Click on “Export” to download the form to the format

you have chosen– With this function, you can save the form to your hard

drive or print a hard copy for your files

Viewing DS Forms• Can open forms individually

• Can open all documents at once– EDN generates all documents

available for the alien• Can open scanned documents

– Reception and Placement Program Assurance form (for refugees only)

– DS 2053 or DS 2054 Medical Examination ‐ ‐form

– Medical History and Physical Examination Worksheet

– Chest X Ray and Classification Worksheet‐– Vaccination Worksheet– Lab Report– X Ray Report‐– Photo– Psychological evaluation

Migration Report

• History of an alien’s residence in the United States– Alien name– Alien number– File number (if available)– Visa type– Quarantine Station where the alien entered the

United States– Status of the TB Follow Up Worksheet for aliens ‐

who entered the United States with a TB condition

What should I do if an alien arrives in my jurisdiction before I receive notification from EDN?

• From time to time, the volume of aliens may be so large it causes a backlog in data entry at EDN headquarters. At such times, an alien may:– Arrive in your jurisdiction before you have been notified by EDN– Go to the health department for treatment, although he or she lacks the necessary

papers to qualify for free treatment– It is also possible that a Voluntary Agency (VOLAG) will know about incoming aliens and

alert you prior to EDN.

• If you become aware of a new arrival for whom you have not received a notification and EDN forms:– Contact the EDN Helpdesk (1 866 226 1617 or ‐ ‐ ‐ [email protected]).– Give the EDN Helpdesk staff the alien number, port of arrival, and arrival date.– The Helpdesk staff will find the paperwork for the alien and enter it into the EDN

system.

What should I do if an alien arrives in my jurisdiction before I receive notification from EDN?

• From time to time, the volume of aliens may be so large it causes a backlog in data entry at EDN headquarters. At such times, an alien may:– Arrive in your jurisdiction before you have been notified by EDN– Go to the health department for treatment, although he or she lacks the necessary

papers to qualify for free treatment– It is also possible that a Voluntary Agency (VOLAG) will know about incoming aliens and

alert you prior to EDN.

• If you become aware of a new arrival for whom you have not received a notification and EDN forms:– Contact the EDN Helpdesk (1 866 226 1617 or ‐ ‐ ‐ [email protected]).– Give the EDN Helpdesk staff the alien number, port of arrival, and arrival date.– The Helpdesk staff will find the paperwork for the alien and enter it into the EDN

system.

Documents and Data

Batch Print• Allows you to define a

specific group of aliens and generate their electronic records in a single file

• Export batch of records to an Acrobat pdf file and print or save

• Filter by any of the listed criteria

ReportsEDN Reports

• The Alien List Report– Line list of aliens by entering one or

more filter criteria– The report can be downloaded to an

Excel format or an Acrobat pdf file to be printed or saved on your hard drive.

• The TB Follow Up Worksheet– Captures information from the U.S.

follow up medical‐ examination of new arrivals in your jurisdiction.

– Worksheets linked to the alien record if the alien has a TB condition

– When the Worksheet is completed, you can enter data from the Worksheet into the EDN system and transfer them electronically to CDC

Help• Contacts

– EDN Helpdesk– State and local contacts– Quarantine Stations– CDC users

• Help– Useful documents– EDN Quick help guide is extremely detailed

guide of how to use EDN– TB Follow Up Guide is in depth review of how to ‐

enter TB Follow up information– New online course for new users will be

uploaded by early October (will only be available within EDN)

TB Follow Up Module‐ Monitors and tracks immigrants and refugees who arrive to

the U.S. with a TB Class condition Upon U.S. arrival, health departments are notified of an

arrival with a TB class condition Immigrant or refugee contact information in EDN is used to

track recent arrivals and refer them to U.S. medical providers for follow up examinations for TB‐

EDN users at U.S. health departments have access to Department of State (DoS) overseas medical forms Overseas medical history TB Class condition details Overseas TB therapy

Resources for TB Follow Up EDN TB Follow Up Guide‐ Domestic Refugee Guidelines

www.cdc.gov/immigrantrefugeehealth/guidelines/domestic/tuberculosis guidelines.html‐

TB Technical Instructions www.cdc.gov/immigrantrefugeehealth/exams

/ti/panel/tuberculosis panel technical‐ ‐ ‐instructions.html

Coming Soon Quick Reference Form Instructions Updated EDN TB Follow up Guide‐ Updated EDN TB Follow up Data Dictionary‐ EDN TB Follow Up Module Data Entry ‐

Training

Revised TB Follow Up Worksheet‐ Projected release – early 2013 Updates

Updates made to multiple sections to increase user friendliness, facilitate accurate reporting, and improve overall organization.

Example.: Revision of Section C. QFT


Thank you!

Amira [email protected]

EDN [email protected]

1 866 226 1617‐ ‐ ‐