Implementation and Support FAQs

What are the cost and licensing requirements for health departments to implement and maintain NBS?

NBS is provided by CDC at no cost. However, the health department must have licenses for some software used by NBS. CDC provides some of these components to the jurisdictions at no cost, but the jurisdiction must maintain licenses for the others. The health department is responsible for the hardware and personnel needed to support the jurisdiction’s implementation of NBS.

Is the system ready to use out of the box?

NBS provides support for surveillance for more than 140 reportable conditions, electronic laboratory reporting (ELR), case reporting, and case notification to CDC, and CDC provides support to jurisdictions during implementation at no cost. However, the system does require configuration prior to use. For example, a state must set up the following:

• internal jurisdictions (counties, parishes, regions, etc.),
• disease program areas (general communicable, vaccine-preventable, etc.), and
• specific conditions on which the jurisdiction conducts surveillance.

What is the process of setting up NBS?

The NBS Deployment Team works closely with the jurisdiction to accomplish the following NBS implementation activities:

• site readiness assessment,
• installation and configuration,
• transition to production, and
• production support.

What are the system requirements?

Minimum Platform Configuration

• SAS 9.3 requires a 64-bit machine.
• Rhapsody may be hosted on one of the 32-bit machines.

* Note: Disk space requirements are highly variable depending upon data volume.

How are data entered into NBS and what are the staffing needs?

Data entry in NBS varies from jurisdiction to jurisdiction. In some jurisdictions information is entered centrally, such as at the state health department. A de-centralized model is used in other jurisdictions, and the data are entered by clerical and investigative staff in local health departments. Some jurisdictions allow the healthcare provider to enter a case directly into the system. The number of staff needed depends on the volume of disease reports that are not received electronically or entered by the provider.

How are data transferred from a previous database to NBS?

NBS offers the ability to migrate data from a legacy system by using a system interface called Public Health Document Container (PHDC). PHDC is based on the HL7 data standard Clinical Document Architecture (CDA). Data from any legacy system can be mapped to the PHDC interface and transferred into NBS. Additional functionality is specifically designed for migration of sexually transmitted disease (STD) data from the CDC STD*MIS system.

Who provides technical support for the database?

Local system administration, including database maintenance, system configuration, and user management, is the responsibility of the jurisdiction. The memorandum of understanding (MOU) that is signed by the jurisdiction and CDC, as well as documentation available on the NBS web site, provides more detailed information on the roles and responsibilities of all system stakeholders.

Can the NBS Deployment Team train our users?

The NBS Deployment Team uses a train-the-trainer approach. Training is provided as part of the initial implementation in a jurisdiction. Subsequent training for each new release also is provided in a train-the-trainer format through specific training sessions that accompany each release. It is the jurisdiction’s responsibility to provide their local users with training, including jurisdiction-specific workflows, policies, and procedures.

Can local jurisdictions request resources to support NBS?

The CDC Epidemiology and Laboratory Capacity (ELC) Cooperative Agreement allows jurisdictions to request resources to help support an integrated surveillance system such as NBS and electronic laboratory results reporting. CDC funds the NBS Support Team, who provides assistance to NBS jurisdictions at no additional cost.

What about Privacy?

NBS ensures the security of protected health information by meeting the requirements of the Health Insurance and Portability Protection Act (HIPPA) and additional state and federal requirements. Jurisdictions are encouraged to collect the minimum amount of information needed to perform public health functions, and access to the information is restricted. Information is stored and exchanged in accordance with current data security standards. NBS does not transmit patient identifying information (such as names, street addresses, telephone numbers, etc.) to CDC.