Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12DATA POINTS: A Health Department Roadmap for Enhancing Data to Care Programs 9 WashingtonState:Utilizing DataSystemsforD2C Health departments have various activities that are both singularly successful, and could be leverage for successful D2C programs. Prior to launching the D2C efforts, Washington State’s Office of Infectious Disease (ID) critically considered all data systems being used within the office. The ex- amination revealed each data system was developed independently and designed for very specific activities: HIV surveillance, HIV prevention, or HIV Care Services. Each system had different data management standards and variables, most of which were incompatible across systems and none were suitable for all D2C needs. As a result of this review, Washington State decided to develop a new data system to conduct, track, and evaluate D2C program activities. The Locating Out of Care (LOOC) data system is the end result at this time. Investigations in LOOC are initiated by populating the database with infor- mation from eHARS (the HIV surveil- lance database) for individuals with no laboratory evidence of care for 12 months. One of the advantages that ID staff have is the ability to easily share data across sections within the office (surveillance, HIV care and prevention, STD, hepatitis C). Once the new data from eHARS has been imported into LOOC, staff following those cases have additional data sources available to conduct their investigations, including: • eHARS (review for any additional information/updates) • Electronic Lab Reporting (ELR) system • HIV laboratory data management system • WA AIDS Drug Assistance Program (ADAP) database • CareWare (HIV case management data system) • Accurint/Lexis Nexis • STD surveillance and partner ser- vices database • Electronic Medical Record systems • Other State’s surveillance data (through surveillance phone calls to the other state’s programs) Data from each of these systems are entered into LOOC and used to determine the next steps in the inves- tigation. Some investigations will be marked as complete in LOOC by DOH staff reviewing the above listed data sources; for example, the investiga- tion could find that the individual was actually in care and the eHARS record had not been updated or the person had moved out of state. If additional information is still needed following the system review, investigations are sent out to local health jurisdiction staff for more specific follow up (e.g., gath- ering information from the last known HIV care provider). Through the inves- tigation, LOOC becomes the reposi- tory for the data collected during the course of the investigations and shows the investigation outcomes as well. One significant challenge with LOOC is that it is a separate data system. For Washington, the next iteration of our D2C work will include D2C efforts in the new state-wide notifiable condi- tions data system launch. This system will incorporate HIV, STD, TB, and chronic disease into one place. D2C will be a part of this new system. Ideally, having all these data in one place will expedite the process of identifying and locating people who have fallen out of HIV medical care. Virginia:Data SharingAgreements To effectively perform D2C activi- ties, HIV surveillance programs need complete and timely measures of PLWH currently in their jurisdictions, and information about if and where they are receiving care, and their health status (e.g., ARV use, CD4 and VL measurements). Challenges that affect HIV surveillance program’s D2C activities include missing data caused by case migration across jurisdictions, out-of-jurisdiction care utilization by PLWH, and the incomplete reporting by out-of-jurisdiction laboratories used by in-jurisdiction HIV care providers. Cross-jurisdictional notification of HIV cases, as directed by CDC and the Council of State and Territorial Ariel VanZandt LOOC Coordinator Washington State Department of Health Ariel.VanZandt@DOH.WA.GOV 360-236-3484 Anne Giuranna Rhodes, PhD Director, HIV Surveillance Virginia Department of Health 804-864-8013