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Division of Global Migration and QuarantineNational Center for Emerging and Zoonotic Infectious Diseases

EDN System Overview

Amanda Dam, MPHPublic Health Advisor, Migration Health Information Nexus UnitImmigrant, Refugee, and Migrant Health Branch

December 2020

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Overview§ Background§ Information Flow of the EDN System§ Features of the EDN System§ Interjurisdictional Transfer Protocol

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Migration Health Information Nexus Unit

(MHINx)

Oversees programmatic and

technical aspects of the notification

process of overseas medical information

and EDN system

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DGMQ Public Health Mission

To reduce morbidity and mortality among immigrants, refugees, travelers,

expatriates, and other globally mobile populations, and to prevent the introduction, transmission, and

spread of communicable diseases through regulation, science, research,

preparedness, and response

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Immigration & Nationality Act

1968

Refugee Act1980

Federal Quarantine Regulations

1798• Prevent and control infectious diseases at origin • Diseases of public health significance• Meet refugees at ports of entry• Notification of state/local health departments

• Prevent importation and spread of communicable diseases

• Authority to issue federal public health orders for defined quarantinable communicable diseases*

• Required medical exam• Inadmissible conditions

(Tuberculosis (TB), Hansen’s disease, gonorrhea, syphilis, harmful behavior, substance abuse)• Vaccines required

* Cholera, yellow fever, plague, viral hemorrhagic fevers, smallpox, diphtheria, pandemic influenza, infectious TB, smallpox, severe acute respiratory syndromes, novel or pandemic-potential influenza strains

DGMQ’s Regulatory Authority

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IRMHB Tools for Improving Health of Immigrant and Refugees § Provide technical guidance for overseas exams

– DS 2054: Medical Examination for Immigrant or Refugee Applicant

– DS 3030: Chest X-Ray and Classification Worksheet– DS 3026: Medical History and Physical Examination Worksheet– DS 3025: Vaccination Documentation Worksheet

§ Improve quality of panel physician examinations § Close collaboration with DOS/PRM and IOM (refugee)

– Presumptive intestinal parasite treatment– Anti-malarial treatment– Hepatitis B screening– Vaccination program

§ Provide domestic guidance§ Provide arrival notification and overseas exams via EDN

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EDN System

§ Centralized electronic reporting system (2008)• Notify state and local health departments of U.S. arrivals• Accessible to CDC users, state and local health departments, and screening

clinics upon request and approval of EDN system access§ Collects health information on all immigrants with Class A or B medical

conditions and all refugees• Vaccination • Anti-malarial and intestinal parasite treatment (refugees)

§ Notification time range: On average, approximately 8 days post arrival§ ~1400 users in ~400 jurisdictions

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Information Flow from Overseas to US Health Partners

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EDN TB Follow-Up Worksheet

National TB Program Objectives and Performance Targets 2025

Ensure the completeness of each core Electronic Disease Notification (EDN) system data item reported to CDC, as described in the TB cooperative agreement announcement.

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EDN System Users

§ To request access to the EDN system, email the MHINx Unit at MHINx@cdc.gov.

§ Requestors will be required to complete an EDN User Agreement and send it back to the MHINx Unit

§ U.S. partners involved in health screenings of arrivals within the U.S. and U.S. territories may request access to the EDN system

§ EDN is best used in the Internet Explorer browser

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Alien List Section

§ Displays a list of arrivals in the EDN user’s jurisdiction(s)

§ This list can be sorted by visa type, TB class, date of arrival, notification date, and TB Follow-Up Worksheet status

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Alien Search Section

§ Allows the EDN user to search for an arrival’s medical record via any of the fields in the screenshot above, including the NTIP ID.

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Batch Print Report Section

§ Allows EDN users to view and print the medical records of multiple individuals at one time.

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Reports Section

Allows the EDN user to: § Generate a PDF of a list of arrivals to their

jurisdiction(s) § Generate a blank TB Follow-Up Worksheet§ Access specific activity reports as outlined above

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Data Download Section

§ Allows the EDN user to download an individual or list of arrivals’ medical records in an Excel Workbook format

§ Information can be further sorted in this Excel file via the “sort and filter” command

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Contacts Section

Allows the EDN user to search for names, contact information, and titles of individuals via state health department, local health department, or other views in each jurisdiction

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Help Section

Contact the MHINx Unit at MHINx@cdc.gov if you have questions about the following:• Missing chest x-ray files• Missing EDN records for US arrivals• Difficulty submitting a TB Follow-Up Worksheet • Medical or identification discrepancies on EDN records• EDN system access and training

• Address updates

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Document List§ Photo § X-rays • 3.5MB to 5MB• Compression ratio will be

provided§ Panel reports• Examples: syphilis,

gonorrhea, sputum test results, etc.

§ Phone numbers directly from CBP

Document ListFile Name Description

facialimage.jpg Facial Image JPG

X-rayimage.dicom Chest x-ray

syphilis.pdf Syphilis laboratory report

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Interjurisdictional Transfer Protocol

§ When a patient moves from State A to State B, State B will now own the patient’s data

§ State A will no longer have access to the patient’s data§ State A may securely send additional information to State B regarding the

patient’s data if needed§ More information may be accessed in the “Help” link of EDN

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Additional Questions?

Contact MHINx@cdc.gov

THANK YOU!!!