An Informatics Approach to STD Surveillance: Data Integration in the Absence of An Electronic Medical Record System

Background: The Centers for Disease Control and Prevention (CDC) has called on STD Surveillance Network (SSuN) grantees to add value to STD surveillance through improved collaborations and data management.

Objectives: To describe the challenges associated with integrating data from multiple data systems in the absence of an electronic medical record system and electronic laboratory reporting of STDs.

Methods: The Virginia Department of Health (VDH) collects and stores demographic, behavioral risk, HIV and STD laboratory tests and diagnoses data in multiple data systems. Data collected from the four local health department STD clinics participating in SSuN were integrated into one SQL database. Customized SQL scripts and data transformation services packages were developed in collaboration with the VDH Data Warehouse to address the unique data issues associated with integrating data from four data systems. The data systems included a Foxpro system, the STD Management Information System (STD*MIS), and three SQL systems including the HIV Counseling, Testing, and Referral Services (CTRS) scan system recommended by the CDC.

Results: Data collected from the four data systems between 1/1/2009 and 9/23/2009 matched at a rate of 76% to 95% with STD*MIS matching at 88%. The HIV CTRS scan system was the most difficult system to integrate due to the data field structures and lack of patient names.

Conclusions: Data integration, though complex and lengthy, expands program capacity and provides the most comprehensive picture of STDs. The most difficult challenges include the lack of a shared unique identifier among the data systems and the data conversion for comparability across data systems.

Implications for Programs, Policy, and/or Research: The processes put forth to facilitate data integration for SSuN will be expanded to include all disparate STD and HIV data systems to create one integrated database that will provide enhanced surveillance data for SSuN and other HIV/STD programs.