Connect (Four) More: Virginia's Strategic “Game” of Interoperability

Background:  The Virginia Department of Health (VDH) - Division of Disease Prevention (DDP) has historically used the Sexually Transmitted Disease Management Information System (STD*MIS) for STD surveillance. In October 2011, CDC announced STD*MIS development discontinuation, requiring jurisdictions to implement alternative data management solutions.   Increased integration efforts across STD/HIV/TB/Hepatitis programs have heightened requirements for improved data interoperability and linkage to healthcare services, including the need for efficient comorbidity analyses, electronic laboratory reporting (ELR), and cross-programmatic data sharing. 

Methods:  The DDP determined a STD*MIS database replacement should serve as a division-wide interoperability system and position Virginia for improved data sharing capabilities.  Staff evaluated customized database development and commercial-off-the-shelf (COTS) systems, and assessed existing market analyses conducted by CDC in 2012. Virginia’s functional requirements included:  data modules for STD/HIV/TB/Hepatitis surveillance, HIV care services and refugee/immigrant health; case management capacity; export functionality to the electronic HIV/AIDS Reporting System; data sharing flexibility; and HL7 architecture for ELR processing.

Results:  The DDP worked with the VDH Office of Information Management and HealthIT, and the Virginia Information Technologies Agency to determine the most cost-effective option.  Consilience Software, Inc. was chosen as the vendor based on existing market analyses, functional requirements and multi-jurisdictional data sharing potential.  Using an interoperability concept, software licensing and project management cost sharing has resulted in 40% of expenditures from non-STD funds.  Server specifications, including the incorporation of additional DDP network requirements, have resulted in a reduction of approximate annual server fees of $36,000.

Conclusions: Programs considering a new surveillance system should evaluate all available options and determine if other programs with similar functions (i.e. HIV/TB/Hepatitis) would benefit from inclusion in the project scope.  Virginia’s cross-programmatic system design has resulted in improved business process modeling, program integration decision points, and project cost sharing.  This integrated approach to system implementation will provide greater operational efficiency across all DDP programs.