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The Mass Care/Reception Center Tracking system tracks the individual's symptoms, vaccination or antibiotic administration and/or release status, as well as referrals to hospital for additional care. The system has been expanded to facilitate patient tracking not only for nuclear incidents but biological, chemical, and others as well. This will also help locate individuals at various mass care reception centers, thus reuniting families in an emergency. In January 2003, the Westchester County Department of Health launched its Community Health Electronic Surveillance System (CHESS). CHESS receives daily data electronically from multiple existing systems, automatically analyzes data to detect potential elevated levels for each syndromic category; and provides electronic reports of results. Any irregularities that may indicate a potentially devastating outbreak are reported and recorded immediately. Building upon the syndromic filters and statistical methods developed by the New York City Department of Health and the Centers for Disease Control, CHESS is advanced in the surveillance arena for its unique flexibility in requiring no standard file format from providers and its reliance on internal Department staff to automate internal processing and communication of results allowing ongoing system refinements. CHESS currently analyzes data from a majority of the 13 emergency departments and is beginning to receive data from ambulatory care settings. Files of varying formats are automatically detected, decrypted, and loaded into the CHESS database based on scripts when files are not received by a specified time. The analysis is scheduled to automatically run at set intervals and a detailed report is emailed to the CHESS team for appropriate action. With the ever growing interest by local health departments to enhance their surveillance capabilities, Westchester County has demonstrated the possibilities of creating a local surveillance system that minimizes reporting burdens on providers and that maximizes use of existing internal resources and technical support.
A database has been designed to capture health surveillance information from local hospital emergency rooms and/or admitting offices, pharmacies, emergency services, physicians, major employers, and schools. The incidence reporting in the database is designed to include but not be limited to data related to natural biological disasters, disease outbreak, emergency room and pharmacy anomalies, increased hospital admissions, employee absences, and increased emergency service activity. The receipt of data from participants has been steadily increasing but it is still not at the desired level. For the most part, each participant collects information in a format conducive to their own operations. In an effort to make participation as barrier free as possible, the County will work with whatever data formats the health providers utilize. Therefore, for each new data provider sending data, additional coding is usually required to reformat incoming data and load it to the database. This effort will continue in 2004 along with expanded statistical and alert reporting using SPSS and SAS. Air and water quality tracking had been previously written as an Access application. However, the database and code became so corrupt that it was not recoverable. The Dept. of Health has requested that the requirements in this area be reassessed and a new application developed using standard tools and DBMS. Efficient monitoring of air and water quality is of great importance to the public's well-being.
A large scale upgrade of the CAD system along with its various interfaces is currently underway. The CAD database and map update workflow will change as a result of this upgrade. Significant productivity gains will be made on some of the map maintenance tasks. There is also improved functionality in several key areas for DES, which will result in better delivery of critical services. Health has indicated that they would like to develop a new application to track camp inspections from the field. A full analysis of the requirements and access methods needs to be explored and an application designed. The expansion of this web based comprehensive family case management system continues to be a major project for the Health and Human Services group. During 2003, this application was expanded to include specific tracking tasks related to the Homeless population, day care subsidy management, electronic case record and numerous administrative and reporting components. During 2004, this application will be expanded further with additional homeless and day care functionality, a generic attendance tracking/compliance component, inclusion of managed care processing (a conversion from the existing Mapper system), incorporation of Resource File Integration data (another conversion from the existing Mapper system) and a generic vendor/provider interface. Additionally, the Case Management System will continue to be embellished with newly identified New York State data sources (ie. NYS DOL’s Welfare to Work Case Management System, NYS OCFS’ Child Care Review System, etc.).DSS will be shifting WMS data entry functions from data entry operators to general case managers. It is anticipated that various statistical/monitoring reports (as yet undefined) will be required to support this initiative. NYS has agreed in concept to a joint project which will allow for posting of grant/billing transactions directly to WMS from local applications (ie. day care subsidy management, homeless payments), without requiring WMS data entry. Detailed analysis by NYS on the project requirements has not yet started so the resource time and skill requirements identified here are truly an estimate, although we anticipate that it may be a fairly complex project. DSS has requested that outdated manual processes currently followed by the foster care payment unit be automated. The general areas identified are child placement, attendance tracking/monitoring and billing/payment. Although we are not yet aware of specific requirements, the major components identified to date are consistent with other common services already developed or under development (i.e. attendance tracking similar to day care, DAAMOS and Homeless) and therefore should not require a substantial amount of resource time to customize for the needs of the foster care program. During 2003, the HealthNet UNIX operating system and all user PC’s are being upgraded to take advantage of the most current technologies available as well as provide better security and backups. In conjunction with this, during the last quarter of 2003 a new HIPAA compliant version of the HealthNet product and related billing procedures will be installed. 2004 activities will include implementation of additional product enhancements which M&M is planning, expanded reporting capabilities, creation of database views for ad hoc reporting, implementation of HIPAA compliant billing procedures and general user support.
During 2003, a project was undertaken to modify/enhance several Access applications used by the Health Department as well as correct database corruption problems and convert the back end databases to SQL Server or Oracle. Significant progress has been made in these areas but additional work is anticipated. These systems include such areas as Petroleum Bulk Storage, Rabies Tracking, Personnel Activity Reporting, Grants Tracking, Ryan White, and Facilitated Enrollment.Health has not yet resolved issues with NYS DOH which would allow a full conversion and cut over to the State’s LeadTrac system from the existing Mapper Lead Tracking System. It is projected that this will now take place during 2004.General system support, unanticipated projects, application upgrades and the move to the new White Plains Public Health Clinic.Implementation of the Forensic Laboratory Information System will be completed by 12/31/2003. Ongoing support and maintenance will be required during 2004 for the Forensic Laboratory, including the Medical Examiner’s Office.During the last quarter of 2003, it is expected that Labs will enter into a contract for a new Laboratory Information Mangement System for the Microbiology Lab. While the selected vendor will be involved with the initial installation and administrator training, significant application and DBA support will be required from IT. General system related support as well as specific support of the new vendor supplied billing system (IMA).General system related support. |
