Electronic Perinatal Hepatitis B Surveillance and Case Management System

Background: In 2008, the Perinatal Hepatitis B Prevention Program, (Peri-hep) began the process of developing and implementing a peri-hep electronic surveillance case management system utilizing the existing Communicable Disease Reporting Surveillance System (CDRSS). Hepatitis B is reportable as per the NJ Communicable Disease Administrative Code.  All positive hepatitis B laboratory data are transmitted electronically to CDRSS by commercial and hospital labs; paper labs are manually entered. All LHD’s and hospitals use CDRSS. The implementation of electronic peri-hep surveillance is consistent with the NJ Administrative Code requirements.

Setting: Department of Health & Senior Services, LHD’s, Hospitals, Health Care Providers.

Population: Pregnant HBsAg + women

Project Description: The program transition included infrastructure changes, permitting a paperless, real-time statewide surveillance program. Policy changes required LHD’s to indicate pregnancy status for each HBsAg + lab in CDRSS for females of childbearing age. LHDs are responsible for case management.  Infants born to HBsAg + women are entered into CDRSS and linked to the mother’s case to facilitate management. Peri-hep staff is responsible for statewide surveillance and will not finalize cases until pregnancy status is indicated. Staff monitors CDRSS to ensure appropriate infant prophylaxis at birth, completion of the vaccine series and post-vaccination serologic testing. In NJ, 369 HBsAg + women are reported annually. Previously, reported cases were women who accessed public sector healthcare. In January, 2009, surveillance expanded to include private and public sector HBsAg + women.  Prospectively, it is anticipated that electronic surveillance will increase reporting of HBsAg + women and increase the percentage of infants completing the vaccine series and post-vaccination serologic testing.

Results/Lessons Learned: All NJ public health partners are active CDRSS users and have welcomed electronic reporting. Peri-hep case management continues to improve. Barriers to investigation exist; most are not related to CDRSS but to the providers and patients lack of understanding and knowledge about hepatitis B.