(P143) USING AUTOMATED SURVEILLANCE CLOSURE TO INCREASE EFFICIENCY OF STI HANDLING

Background:
Second in volume to Chlamydia reporting, gonorrhea cases have steadily increased during 2018 (227 per 100,000 persons) to 2022 (255 per 100,000). To manage the rise in gonorrhea and other STIs, and make the most efficient use of staff time, the NC DPH developed an automated case closing protocol in the reportable disease surveillance system, NC EDSS.

Methods:
Our data set included confirmed and probable gonorrhea cases, reported by paper lab report, electronic lab report (ELR), and other means. NC EDSS, a Maven-based system, was programmed to automatically close gonorrhea cases with complete case data and full documentation of CDC-recommended treatment at 30 days following the date of creation. Case handling outcomes for cases created prior to or during the period and closed during or after the period were compared for a two-month period prior to (April-May 2023, “pre-autoclose”) and a two-month period following implementation (September-Oct 2023, “post-autoclose”).

Results:
Similar numbers of cases were open during both periods (pre-autoclose: 3,976; post-autoclose, 4,126). The mean time of report to CDC decreased by 17 days (pre-autoclose: 40 days; post-autoclose: 23 days). This decrease was similar for cases reported by ELR (75% of cases) (from mean of 41 to 22) and cases entered by staff (from mean of 39 to 23). Staff reported more opportunity to clean and improve case data, including initiating work with local health department staff closer to case creation date. More capacity to identify common errors with reassignment of cases, demographics, clinical findings, and treatment have fostered training opportunities.

Conclusion:
The goal of this automated approach was to improve case handling and reporting efficiency. As cases rise, funding for sexually transmitted disease surveillance remains level and salaries rise, this automation supports a reasonable workload for the staff we have and serves as a pilot for automated case closing for other conditions.