Technical Team Lead, Georgia Department of Public Health. Epidemiology Preparedness Director, Georgia Department of Public Health

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1 Assignment Location: Georgia Department of Public Health Atlanta, Georgia Primary Mentor: Secondary Mentor: Karl Soetebier, MAPW Technical Team Lead, Georgia Department of Public Health Wendy Smith, MPH, MA Epidemiology Preparedness Director, Georgia Department of Public Health Mentor Information Karl Soetebier has over 15 years of software development experience and has served in his present capacity with the Georgia Department of Public Health since Since its initiation, he has successfully managed the development and implementation of multiple SendSS (State Electronic Notifiable Disease Surveillance System) modules, including SendSS Newborn Module, SendSS Outbreak Management Module, Electronic Laboratory Reporting Module, the Emergency Medical Services. This has involved the management of several simultaneous development efforts through the full life cycle from requirements to testing and implementation, as well as communication with and coordination of multiple stakeholders and groups within the public health organization and technical coordination with external partners. This responsibility included architecting, designing, and developing the SendSS messaging backbone for achieving secure intrasystem communications and integration that involved the development of a suite of program modules to integrate the SendSS application with CDC developed PhinMS, Orion Technologies Rhapsody and Oracle database UTL_TCP functionalities. This communications backbone currently supports 70+ real time and daily data feeds such as the collection of ED visits for syndromic surveillance from acute care facilities in Georgia, electronic laboratory reports from major reference labs and various hospitals, and outbound integration with the CDC and other partners. Some of Karl s publications include: Schnall AH, Wolkin AF, Noe R, Hausman LB, Wiersma P, Soetebier K, Cookson ST: Evaluation of a standardized morbidity surveillance form for use during disasters caused by natural hazards. Prehosp Disaster Med 2011;26(2): Building An Interoperable System of Systems for Perinatal Hepatitis B Case Management, Conference: 45rd National Immunization Conference 2011 Centers for Disease Control and Prevention Susan T Cookson, MD, MPH, Karl Soetebier, MAPW, Erin L Murray, MSPH, Geroncio C Fajardo, MD, MBA, MS, Alex Cowell, Cherie Drenzek, DVM, MS, and Randy Hanzlick, MD: Internet Based Morbidity and Mortality Surveillance Among Hurricane Katrina Evacuees in Georgia. Prev Chronic Dis October; 5(4): A133. Published online 2008 September 15. PMCID: PMC Karl Soetebier currently serves in a leadership role of 8 member development team for PHIP/SendSS. In this role, he supervises and mentors 5 PL/SQL developers and an Oracle DBA and 2 Analysts. Daily responsibilities include coordinating daily development activities to meet project objectives, providing technical guidance and support for development effort, serving as a resource for coding best practices, performing code review, and decision making in matters that affect overall system architecture and

2 design. While he has not been the primary mentor for fellows or interns, he has worked extensively with them in supporting their work to carryout assignments that involve DPH informatics activities. His engagement on academic and scientific groups include: 2006, 2007, and 2010 Scientific Program Committee member, International Society for Disease Surveillance 2011 Co Chair Scientific Program Committee, International Society for Disease Surveillance Wendy Smith, the secondary mentor, is the Emergency Preparedness subject matter expert in the Epidemiology Section and has been the Syndromic Surveillance Program Coordinator for the Department since Responsibilities have included facility recruitment, healthcare and public health personnel syndromic surveillance module training, data monitoring and response, design of formalized response protocols, process and program strategic planning to adapt to evolving needs of the Department and the implications of the Affordable Care Act and the Syndromic Surveillance Program s transition to standards prescribed by Meaningful Use. Ms. Smith will provide the public health contextual framework for the fellow s activities. Recent publications include: Poster School health: A novel school nurse clinic surveillance project in coastal Georgia submitted to and accepted for next month s ISDS meeting. Amanda Feldpausch, Wendy Smith, Karl Soetebier and Marsha Cornell (School Health Services, Effingham County) Poster Priority Health Interventions and Preparedness: A Novel School Nurse Clinic Visit Surveillance Program in Coastal Georgia submitted to and currently being presented at APHA in New Orleans. Amanda Feldpausch, Cherie Drenzek, Wendy Smith and Marsha Cornell (School Health Services Effingham County) See above regarding relevant experience; Ms. Smith does not have supervisory responsibilities at present. She has served as a mentor for a Public Health Associate and numerous MPH candidates and interns. She does not have any academic affiliations. Assignment Description The Georgia Department of Public Health (GDPH) is the state public health agency; governance is shared between the state and 18 local health districts that administer services in 159 counties. About 4,500 employees work at the state and local levels. GDPH has two major divisions Health Protection (epidemiology, infectious diseases, environmental health, state laboratory, EMS) and Health Promotion (chronic diseases, maternal and child health, WIC). The divisions are supported by central units including Information Technology and Informatics and Applications, which is responsible for the development and operation of GDPH specific applications including electronic reporting and our interface with the State s Health Information Exchange, GaHIN. The fellow will have a collaborative placement, primarily working with the Public Health Integration Projects team which is part of the Informatics and Applications Unit, and interacting extensively with the Epidemiology Section, which is a major business owner for the Informatics and Applications Unit. The Public Health Integration Projects team is responsible for development and implementation of technology solutions to meet the surveillance and programmatic information needs of a range of

3 program areas within the department. This team includes a staff of 6 developers, 1 database administrator, 3 analysts and a director. This team manages and maintains the Public Health Information Portal and its suite of applications. The Epidemiology Section carries out a number of activities to identify diseases and describe health conditions, assess the health of Georgians, and develop recommendations to control diseases and improve the overall health status in the state. These include: conducting active and passive surveillance to detect diseases and adverse health conditions; investigating reports of acute diseases and outbreaks; recommending appropriate prevention measures, treatment, and control; monitoring and investigating reports of unusual health conditions; conducting data analyses and disseminating information from surveillance systems; and providing guidance for healthcare professionals, facilities, and other agencies and organizations regarding disease prevention and control. The Section, headed by the State Epidemiologist, works closely with the Georgia Public Health Laboratory, the Environmental Health Section, and many of the Department s prevention programs, as well as with District Epidemiologists in each of the 18 local District Health Offices. Staff includes several medical epidemiologists and over 40 master s prepared public health professionals. Day to Day Activities The fellow s focus will be expanding the interoperations between the GDPH Public Health Information Portal (PHIP) and the Georgia Health Information Network (GaHIN). The PHIP, which has emerged from the state s electronic notifiable disease reporting system, supports a range of the department s operations needs with a heavy focus on acute disease surveillance activities, as demonstrated in its recent engagement for Ebola. In expanding the scope of PHIP, the fellow s day to day activities will touch on all aspects of the project lifecycle from requirements gathering, to solutioning, to project management, development, testing, implementation and evaluation. As part of a small group, the fellow will have many opportunities to engage in each area while being assisted by and working with the primary mentor to drive the project to completion. The fellow will work with the secondary mentor around epidemiologic concerns such as case management, laboratory reporting, and disease investigation protocols. The fellow will work closely with various project stakeholders including multiple levels of state and local public health epidemiology and our partners at the Georgia Heath Information Network and the private health care institutions they serve. The fellow will participate in regular meetings, conference calls, etc. as necessary and have the opportunity to participate in relevant workgroups and/or conferences. The fellow will have regular contact with the primary and secondary mentors, who have a long standing and close working relationship, to develop goals and objectives, seek guidance, review work products, and provide updates on progress. Potential Projects include: There will be one primary project, however, as other relevant activities emerge, the fellow will have the opportunity for involvement. 1. PHIP / GaHIN Interoperation The principal project for the HPIF fellow focuses on expanding and deepening the interconnection and interoperation between its Public Health Information Portal (PHIP)

4 system and the Georgia Health Information Network (GaHIN). GDPH s PHIP, which grew out of our State Electronic Notifiable Disease Surveillance System (SendSS) that has been in existence almost 15 years, supports a range of the department s operational needs. SendSS has a heavy focus on acute disease surveillance activities, but is also the platform for maternal child health epidemiology, immunization support services, emergency medical services licensure and WIC programmatic support functions, among others. GaHIN is operated as a quasi governmental, not for profit corporation in support of developing Georgia s network of networks health information exchange and interconnects with regional HIEs and health care institutions across Georgia. While GDPH has been collaborating with GaHIN for over two years and has several operational interconnections between public health systems and the network, much work remains to be done. The current PHIP interfaces are unidirectional and provide for the transfer of electronic laboratory reports and syndromic surveillance messaging. The next phase of the interaction with GaHIN, which will be the focus of the Fellow s efforts, involves becoming a fully participating member of the exchange and establishing a patient master and patient document repository that will enable the bi directional exchange of public health data between the systems. A high level timeline of the project is a process analysis and requirements phase lasting approximately 1 month, followed by a solutioning and architecture phase of 1 ½ months. The procurement and development and testing phase will then take approximate 5 7 months. The remainder of the time will be for go live, evaluation and modification of the solution. This project will benefit the citizens of Georgia, Georgia Public Health and health care providers in Georgia in three specific ways. First, improving access to patient medical records in support of epidemiologic case investigations will benefit GDPH in reducing amount of staff time needed to complete case investigations. Second, the burden on participating facilities will be reduced by allowing conversations with public health to be more infrequent and, when needed, come from a position of mutual knowledge regarding the patient at hand. Lastly, on a population health level, it will benefit the citizens of Georgia by providing information to improve public health's ability to more efficiently ascertain and mitigate public health threats. Public Health impact: The potential impact of having access to the data available through a bi directional link between PHIN and GaHIN is extensive. In the short term, the communication of critical health information will enable result in improved communication between healthcare providers and public health around individual patient issues and more efficient and effective surveillance systems. In a more intermediate timeframe, the improved communication should facilitate better linkage between the healthcare providers and public health with this interaction resulting in improved reporting and use of recommendations. And, ultimately, as more and better data is generated, it can achieve

5 the goal of meaning use in evaluation and analyses that will be used to drive decisionmaking for policy formulation and program development and implementation. Project Activities/deliverables: The fellow will serve as the hands on project co leader along with the primary mentor. In addition to overall coordination and planning activities, specific duties will depend to some extent in the fellow s prior experience and skills. Based on this, the primary mentor will provide needed support and supplementary assistance to ensure successful completion of the project. The deliverables for this project will include: A detailed analysis of current and proposed processes related to the interoperability and integration of PHIP and GaHIN. Architecture of the solution for the bi directional linkage PHIP and GaHIN based on research and the identification of an effective approach. Procurement of the requisite software (off the shelf, COTs, and/or customized based on analysis) Testing and implementation support in the development of software built by the PHIP team. Post production evaluation of the deployed solution based on available time as a fellow.