Improved Case Finding of Hepatitis B Positive Women of Child-Bearing Age Through Implementation of a Web-Based Surveillance System

Learning Objectives for this Presentation:
By the end of the presentation, participants will be able to recognize the benefits of a web-based surveillance system for enhancing program efficacy.

Background:
In September 2006, the Massachusetts Department of Public Health (MDPH) implemented a web-based surveillance system (MAVEN). The system was configured to capture data for all reportable diseases. Specific case management workflows were developed for the Perinatal Hepatitis B Program (PHBP). Prior to September 2006, MDPH began recruiting hospital and commercial laboratories to participate in electronic laboratory reporting (ELR).

Objectives:
Through the implementation of MAVEN and ELR, MDPH hoped to improve the timeliness and completeness of reporting, as well as provide tools for streamlined case management to the PHBP.

Methods:
Surveillance epidemiologists from the Office of Integrated Surveillance and Informatics Services (ISIS) configured MAVEN to capture all variables on the Hepatitis B Case Report Form and those required for case management by the PHBP. Epidemiologists also worked with PHBP staff to gather requirements for development of HBV-specific workflows in order to improve the identification of women requiring case management, the tracking of vaccination status and to streamline case management activities.

Results:
Since 2005, the point estimate in Massachusetts for HBV-positive pregnant women has been 542 cases/year. The number of HBV-positive pregnant women identified has increased since 2005 (412 women in 2005, 528 in 2006, and 457 to 10/31/07). The PHBP estimates that 555 pregnant women will be identified in 2007.

Conclusions:
There has been an increase in the number of HBV-positive pregnant women reported in Massachusetts since 2005. This increase was most likely due to the implementation of a new web-based surveillance system (MAVEN) in conjunction with more hospital and commercial laboratories initiating ELR. Streamlined business procedures have been integral in improving case management practices, enabling the PHBP to identify, investigate and effectively manage more HBV-positive women.