Improvements in Timeliness of Syphilis Surveillance and Disease Intervention Activities from a Newly Implemented Surveillance/Case Management System

Background: Timeliness of disease reporting by laboratories and providers is a critical attribute of surveillance systems; improvements can lead to earlier disease detection and intervention efforts. The New York City Department of Health and Mental Hygiene has taken measures to improve timeliness of reporting, including mandating electronic laboratory reporting (ELR), and transitioning from a surveillance/case management system that required time intensive manual importation of ELR to one that automatically receives ELR nightly. We compared the timeliness of syphilis reporting and related activities following the introduction of a new CMS.

Methods: Syphilis tests reported to two different systems (STD*MIS, February-May, 2010 and Maven, February-May, 2012) were compared using independent sample t-tests. We determined timeliness using the following dates: specimen collection date, test receipt date by system, and surveillance staff review date.

Results: Nearly 10,000 syphilis tests were received by ELR during each evaluation period. Average time between specimen collection and test receipt decreased significantly from 8.6 days (median=6) using STD*MIS to 4.1 days (median=3) using Maven (p<.001). Average time between test receipt and staff review increased from 3.0 days (median=2) using STD*MIS to 6.4 days (median=3) using Maven (p<.001). Overall, average time between specimen collection and staff review decreased from 11.6 days (median=8) using STD*MIS to 10.5 days (median=7) using Maven (p<.001).

Conclusions: Automated receipt of ELR by Maven improved overall timeliness of syphilis surveillance and initiation of disease intervention activities. Because Maven receives ELR nightly (versus the less systematic, manual importation using STD*MIS), tests are available for review on weekends and holidays when staff are not working; this may account for the observed increase in average staff review time. Nevertheless, worker performance is an area for further improvement and evaluation. This analysis will be used to set system and staff performance standards that are continuously monitored, evaluated, and improved.