Update on the Development of the Computerised Infectious Disease Reporting (CIDR) System

Update on the Development of the

Computerised Infectious Disease

Reporting (CIDR) System

J. Brazil, G. Cullen, J. Foy, C. Grogan, M. Houlden, D. Igoe and L. O’Connor.

National Disease Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1.

CIDR

• One national database of information on infectious diseases and Anti-Microbial Resistance

• Combines and links clinical epidemiological and laboratory based information

• Uses web technology for access • Needs to be flexible and scaleable • Needs to be secure

CIDR Partners

P u b lic In te rn e t / G o v e rn m e n t V P N C ID R D a ta b a s e D e p a rtm e n t o f P u b lic H e a lth L a b o ra to ryC lin ic a l C o m m u n ity C a re O ffic e N a tio n a l D is e a s e S u rv e illa n c e C e n tre F o o d S a fe ty A u th o rity F o o d S a fe ty P ro m o tio n B o a rd H e a lth a n d C h ild re nD e p a rtm e n t o f H e a lth B o a rd

CIDR Timescales

• 2002 Design

• 2003 Development and User

Acceptance Testing

• 2004 Pilot implementation in NEHB and 4

Reference Laboratories (Meningococcal Reference Laboratory Temple Street

Hospital, MRSA Reference Laboratory St James’s Hospital, National Virus

Reference Laboratory UCD, Salmonella Reference Laboratory University College Hospital Galway) – January to March

CIDR Technologies

• The core CIDR system has been developed on a Microsoft platform – Windows 2000 – IIS – SQL 2000 – .Net • Browser-based clients

CIDR Technical Architecture

• n – tier Architecture

– User Services – Directory Services – Business Façade – Business Rules – Data Access – Data Persistence

CIDR Core System

User Services Layer

Business Façade Layer

Data Access Layer

Technology Infrastructure

Presentation Sub-system

Business Sub-system

Data Sub-system

Business Rules Layer

Data Persistence Layer Directory Services Layer

Web Server Directory Server Application Server Database Server

CIDR Technologies

• RSA authentication

– To confirm that the user is who they purport to be

• Active Directory Services

– To manage user access to data and functionality through the CIDR application

• XML

– To manage CIDR masterfiles and to enable the

transformation and translation of data exported from Laboratory Information Systems

Local Requirements

• Modern PC running Internet Explorer 6

• Network connection to Government

Partner Connectivity Issues

• Availability

• Bandwidth

• Cost

Government Virtual Private Network

eGovernment Network Agency Network 10Mb Ethernet connection carrying "eGov-Hosting" VPN WAN link to eircom BIP Agency's Firewall Ethernet connection to Agency's private network Managed 3640/3725 router 10Mb Ethernet

connections for Services", InterAgency", "eGov-Dialin" and Agency Private VPNs

Government VPN Configurations

• Hosting

• Services

Technical Challenges

• No unique health identifier

• Very limited or non-existent national coding standards for e.g. GPs or their practices,

hospitals, etc

• LIMS populated with local codes, data

unstructured or semi-structured,other sites not computerised

• Relationships between data items not defined or enforced

Data Protection

• CIDR will contain personally-identifiable health information

• Some of this information may be highly sensitive

• There is a clear statutory obligation under the Data Protection (Amendment) Act, 2003 to

ensure that this information is secured to a degree commensurate with the potential for harm to the data subject

Information Governance

• Appropriate data sharing

– Defined access rights – Policies and procedures – Audit

CIDR User Access Rights

• Defined by Role e.g.

– Public Health Specialist – Area Medical Officer – Surveillance Scientist – Medical Scientist • Defined by Location e.g. – Health Board – Hospital Laboratory – Health Agency

• Defined by Disease e.g.

– Anti-Microbial Resistance – Sexually Transmitted

User Access to CIDR Application

• Who you are

– Username

• What you know

– Password

• What you have

Application Access Rights Managed by

Active Directory Services

Management of Access to Differing

Areas of Functionality

Report Writer

• Allows data in a complex relational

database to be viewed in a more

user-friendly manner

• Allows complex reports to be created

relatively easily

• Ensures that the integrity of the

underlying data is preserved

Reporting Framework

Operational Database Reporting Database (Cube) Operational View Informational View

Data Capture and Use Query, Reporting, and Analysis

Operational Systems Informational Systems SQL Server 2000 Relational Database With Analysis Services CIDR

Application _{Business Objects}

CIDR Design and Development

• CIDR Project Team

• Fujitsu Consulting

• With extensive support from CIDR

partners in Health Boards, Hospitals,

Health Agencies, the Department of

Health and Children, and from other

NDSC staff