Background:
The Michigan Disease Surveillance System (MDSS) is a PHIN-compliant electronic disease reporting system initiated in July of 2004 for communicable disease reporting. STD reporting was integrated into the system in January 2005, including both electronic laboratory reporting and web-based morbidity data entry.

Objective:
To assess changes in completeness, timeliness, ease of use, and other system attributes

Method:
Gonorrhea and chlamydia cases reported between January 1, 2005 and June 30, 2005 were exported from the system and compared to cases reported during the same time period in 2004 housed in a paper-based central database.

Result:
There was no change in completeness in several variables including age, sex, zip code, and county of residence. There were significant decreases in the timeliness of reporting for both gonorrhea and chlamydia. There were also decreases in completeness of race. Information was gained however, in that previous to MDSS, site of specimen was not collected, and, in 2005, this variable was complete for 92% of gonorrhea and chlamydia cases. Previous to MDSS, all cases had an information source listed as either STD Clinic or Private Physician/HMO. All NETSS source codes for this variable are now used, despite some decreases in completeness.

Conclusion:
The MDSS system has presented greater challenges in STD reporting then our previous system. The time constraints this has added to the local health department were underestimated, as was the unknown information frequently reported by electronic lab reporting. As states move towards NBS and PHIN-compliant systems, it is important to assess the impact of these changes prior to initiating a data system change.

Implications:
Web-based reporting systems can have major resource implications for state STD programs. Often, the morbidity component of these systems are designed for communicable disease, not STD reporting. These implications must be evaluated and assessed in an on-going manner.