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Perinatal hepatitis b module
- 1. Perinatal Hepatitis B Module
- 2. First Day on the Job!
- 3. Washington State • Average 350 reported cases annually for Perinatal Hepatitis B Prevention Program (PHBPP) • Expected cases are predicted to be around 700 annually • Local Health Jurisdictions (LHJ) manage cases
- 5. Perinatal Hepatitis B Module • Case management model • Assign users to clients • Imports birth dose information from IIS to PHB Module • Reminder/ Recall
- 8. Contact info Shana Johnny, Perinatal Hepatitis B Coordinator shana.johnny@doh.wa.gov Steffen Burney, Technical Assistance Specialist steffen.burney@doh.wa.gov Chrystal Averette, AFIX Coordinator chrystal.averette@doh.wa.gov
Editor's Notes
- I am Chrystal Averette, the AFIX Coordinator from the Washington State Department of Health. On November 30, 2007 I left Active Duty service as a medical technician in the Air Force and began my career at DOH on Dec 3rd to begin work with the Perinatal Hep B module. On Dec 3 there was a huge flood in Western Washington due to heavy rains, but it seemed no different than any other heavy wind and rain storm. This picture taken was about 30 miles south of our agency on I- 5 and about roads north of the Lacey, Olympia, Tumwater were also covered with water and actually made us an island. The route that I tested out days prior to my first day was now a lake so I did a quick about face and took another route to work which made me15 minutes late. This was not acceptable to me because in the military if your on time your late. I was so nervous and I approached the guard stand to have them call someone to take me upstairs, and the guard said no on is answering. He showed how bad the storm and flooding was, I was actually the first person to get to work from my agency. My first thought is this an omen telling me about this job!
- Washington State reports about 350 Cases annually for PHPBB and the amount expected cases are predicted to be around 700 infants born to mothers who have Hepatitis B , these cases are managed by our Local Health Jurisdictions. To give some background information to those are not aware of the goals of the PHBPP, it is to prevent the transmission of a mother who has been diagnosed with hep B from passing it on to their infant. If an infant is given a prophylaxis immunioglobin called HBIG and the hep b birth within 12 hours it is 85-95 % effective preventing chronic hep b infection. The effectiveness increases as the infant completes the 3 dose series and then is Case management involves tracking mothers due dates to ensure that the hospital provides appropriate treatment so that these infants do not slip through cracks, then it moves to ensure that the infant receives 2 other dose and then is tested to ensure that the are not infected and that they are protected by vaccination. This is more than 1,400 actions a year that need to be tracked and managed to ensure that the infant is receiving the appropriate treatment and follow up to prevent chronic disease So this drives the need for sophisticated tracking system that has multiple features and reminders so that the infant is protected from this chronic disease that lead leads to liver damage and liver cancer.
- When I started in 2007 we had an access data base that had about half our case that were entered when paper forms where mailed to us. Our largest jurisdiction would mail a disk with an excel file that included case up dates and would have to be ran through this special program to pull out data for annual reporting. The original version of the module that was created was more for reporting. Each of our local health jurisdiction that have most of the cases had similar systems that were not being supported by their IT department. We would receive case reports mailed or faxed to us from local health to input into our data base, there was a lot of time spent on each case for both our program and local health. Our first intent of the Perinatal Hep B Module was more for CDC reporting and for internal activities management, but we realized that there was a greater need for both case managers and for our program.
- We started making improvements to our PHB Module to reflect the needs of our LHJ case managers to record the different activities that were associated with each case for better tracking of active cases. All local health jurisdictions are reporting data to us via the module which eliminated staff time for data entry. We are able to run reports and follow up with case managers about specific cases that they were assigned to ensure better completion of hep b series and post vaccine serology Local health are able to run reminder/ recall on clients that are due or over due for services and follow up with providers or the parents, they can generate letters that are editable for their case. Other functionality included importing data from the IIS into the PHB Module for the hep b series, note section to document information about client interaction, and we use it for both program evaluation and annual reporting.
- The CDC Annual Report for PHBPP is very complex questionnaire, we use the annual assessment data to help populate the report. The annual assessment shows both client information and then reports statistical data, this helps us to follow up with cases that are incomplete and ensure that they have completed all required services. The module is our tool to complete this annual report and since the beginning of its use it has drastically reduced the time it takes to complete it. We use data from the annual assessment for other program activities such as increasing post vaccine serology or education with hospitals that miss the prophylaxis treatment for the infants.
- On an additional note on some of the other work we do to support of hep b prevention., we did a social media campaign for the Perinatal Hep B Birth Dose this past May .We used a crowd sourcing application called Thunderclap which we were able to simultaneously send a message out that reached over 1.1 million people about the importance of birth dose for every infant. I was also asked to see if I could measure birth dose rate in our hospitals using data from the IIS. I was able to accomplish this with hospitals that have an HL7 interface. We also did other social media work to educate all people all ages on the importance of the hep b vaccine.
- Here is the contact information for our program leads on the Perinatal Hep Program and module and if you have any question about measuring the birth dose you can contact me Chrystal Averette