How do you train 351 towns to use a web-based surveillance system?

Objective:
Summarize the Massachusetts Department of Public Health’s (MDPH) progress towards deploying a PHIN compliant web-based surveillance and case management system, the Massachusetts Virtual Epidemiologic Network (MAVEN) at the local level.  Provide recommendations for training and implementation. 

Background:
MAVEN has been live in MA at the state health department since September 2006 and in an expanded pilot since July 2007 at several local boards of health. Although this project is expected to result in faster and more accurate disease reporting and follow up, as well as better communication between MDPH and local health departments, there are significant challenges to implementation.

Methods:
In the summer of 2007, MDPH began deploying MAVEN to a pilot group of approximately 15 local boards of health, with a long-term goal of making the web-based system available to all 351 towns. Pilot sites were chosen based on general interest and level of comfort around using computers. MDPH staff created extensive training materials and proficiency tests. In addition, MDPH conducted on-site and web-based trainings as well as a Governance council to ensure local participation in the development and implementation process.

Conclusions:
Electronic, web-based reporting has significantly improved the completeness and timeliness of disease reporting and investigation. Extensive training materials, on-site and web-based trainings, and a well-supported Help Desk are critical to the ongoing success at the local level.  Although there has been a great deal of interest and support for this project, there are many issues that should be considered prior to wide scale roll out. These include long term financial support, clarification of business rules, security, user training and support, and wide spread technical limitations of local staff. Massachusetts has found that deployment of a PHIN compliant system to local boards of health remains a challenge; it is also very desirable in the long term for relationship building, communications, and disease prevention.