Background: Used correctly, Visual Case Analysis (VCA) is a valuable disease intervention case management tool. VCA utilizes a unique plotting sheet along with a specific set of symbols to graphically illustrate related cases of early syphilis. A completed VCA chart is analyzed and case-specific questions developed to guide case management activities. For over a decade, case managers have recognized that a computer-based VCA program could increase consistency and precision of case plotting resulting in more accurate analysis and improved syphilis partner services.
Methods: After participating in a 2012 CDC training for VCA, New Mexico Department of Health (NMDOH) STD Program staff began investigating options for developing a computer-based program to accurately construct a VCA sheet. A rudimentary program was initially designed and shared with CDC’s STD Training Unit. With STD Training Unit staff serving as the VCA subject matter experts, the NMDOH engaged technical experts to write complex Excel formulas, incorporate Visual Basic and link the VCA plotting tool to existing databases.
Results: Two versions of a VCA plotting tool (VCAMON) have been developed. One is a stand-alone program that utilizes data entered directly or imported from a specific data set. The other version is integrated into the STD surveillance data system PRISM. Each version plots:
- Primary and secondary syphilis symptoms
- Dynamically adjusting critical period
- Exposure dates
- Inoculation point
- Other medical information
- Multiple syphilis generations
- “Ghosted” symptoms for source and spread termination.
- List of “Forget Me Not” Questions to consider during intervention activities.
Conclusions: Utilization of VCAMON can improve the overall consistency and accuracy of VCA plotting enabling individual disease intervention specialists (DIS) to focus on the most relevant analysis and case management activities, ultimately making activities such as re-interviewing and clustering more productive.