VISITS Virginia Infant Screening and Infant Tracking System

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VISITSVirginia Infant Screening and Infant
Tracking System

• Nancy Ford
• Virginia Department of Health
• Updated March 1, 2004

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What is VISITS?

• VISITS is a Web-based integrated database system
  that tracks screening results for four programs
  and services administered by the Virginia
  Department of Health (VDH).
• Virginia Congenital Anomalies Reporting and
  Education System (VaCARES, Virginias birth
  defects registry)
• Virginia Early Hearing Detection and Intervention
  Program
• Virginia Newborn Screening Services
• At-Risk for Developmental Delay (Part C)

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VISITS Integrated System Model
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Why Was VISITS Developed?

• Purpose
• Single Record
• Reports and Surveillance
• Process
• Requirements document completed based on program
  needs and requirements.
• Software was developed based on hospital focus
  groups and program administrators.
• User acceptance testing was conducted.

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Who Developed VISITS?

• VISITS was developed through a contractual
  agreement with Welligent, LLC under the
  leadership of VDH.
• A multi-discipline, multi-agency task force
  guided the initial development.
• Subsequent work groups were formed as needed to
  identify and address various issues.
• VISITS Issues Work Group (VDH, Welligent)
• VISITS Quality Control Work Group (VDH)
• Major funding was provided by (1) Part C of IDEA
  (DMHMRSAS), (2) MCH Bureau (Title V Block Grant),
  and (3) CDC Birth Defects Surveillance
  Cooperative Agreement (PA 01011)

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How Secure is VISITS?

• VISITS Platform
• Developed in Oracle 8, Deployed Using Oracles
  Web-Application System
• Basic Security
• Cisco PIX Firewall
• 128 Bit Encryption
• Unique User Names and Passwords
• Assigned Security Rights
• HIPAA Compliant

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Key Security Components

• Firewall
• Defends against unauthorized users accessing a
  private network (Usually the first line of
  defense).
• A firewall is a piece of software, hardware, or a
  combination of both.
• Screens all messages coming or going to meet
  certain security criteria.

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Key Security Components

• Encryption
• Encryption is the process of encoding data to
  prevent unauthorized parties from viewing or
  modifying it.
• Up to 3.4 trillion billion billion billion--or 2
  to the power of 128--possible combinations of
  zeros and ones.
• Prevents unwanted access to data, documents, and
  e-mail message.

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Key Security Components

• Password Protection
• All users are assigned unique usernames and
  passwords.
• Only those users with valid logins can access the
  data.
• Assigned security rights
• Security rights limit a users ability to view,
  edit. update, and/or delete different
  types/levels of data.
• Limits the level of detail for reporting.

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VISITS - Data Security
VNHSP
VNSS
VaCARES
HPIT
Cisco Router
PIX Firewalls
128 bit encryption validation
128 bit encryption validation
10/100 Hub
SUN Ultra 10 Oracle 8i database Development
Server
SUN E5500 Oracle 8i database Oracle Web
Application Server
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Is VISITS Fully Operational?

• Modules That Went Live in 2002
• Hearing Screening / Follow Up Module
• VaCARES Module
• Module Piloted in 2003
• At Risk Module
• Evaluation target completion date is August 2004.
• Module to be Completed in 2004
• Newborn Screening Module (For VDH Administrators
  only)

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What does VISITS look like to the end user?

• All VISITS Users enter the secure system through
  the following VISITS Public Web Page (next slide)
• http//www.welligent.com/visits/

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Hearing Screening Users Click Here
VaCARES (Virginias birth defect registry) Users
Click Here
At-Risk (for Development Delay, Part C)Users
Click Here (Pilot Phase)
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Click to Proceed to Next Screen
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The user enters their unique user name and
password in this pop-up window.
DO NOT CLICK. For security reasons, users are
requested not to have system remember password.
After user clicks OK, the VISITS Messaging Center
will appear (next slide)
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VISITS Messaging Center

• The VISITS messaging center is a centralized area
  for
• Controlling user access to software modules.
• Posting, modifying, and deleting announcements to
  system users.
• Sending, receiving, archiving, and deleting
  internal system email messages.
• Posting reminders to oneself.
• Maintaining user information.
• Providing access to online help topics.
• Providing an on-line mechanism for user to post
  questions to system administrators.

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VISITSMessaging Center
VISITS is customized to each user with a
personalized welcome message along with a message
that a users agency may want posted for viewing.
Depending on a users level of access and
assigned rights, software modules will/will not
be accessible. Modules with Check Mark icons
signify that a user has access to this module. A
Padlock icon will signify that a user is
restricted from using a module and will prevent
entry into that module.
The VISITS System provides an easy-to-use screen
for displaying and allowing users to view and
read posted announcements. New announcements are
listed first with High Priority announcements
showing in red.
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VISITSMessaging Center
VISITS houses an integrated internal email
system. This email system allows users to send
emails to registered VISITS ONLY. VISITS
messaging is a robust component with tremendous
functionality such as

• Forward
• Reply
• One touch personal signature additions

• Create
• Delete
• Archive

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VISITSMessaging Center
Users can also schedule personal reminders.
Reminders are set for certain dates at certain
times and can be dismissed or set to snooze for a
certain period of time.
To support users and administrators, documents
and forms that are posted on the VISITS messaging
center for viewing and downloading.
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VISITSMessaging Center
User information, including access level, is
posted in a snap-shot view. Users are given the
ability to update their information at any point
in time. This makes it easier for administrators
to contact users in the event questions or
problems arise. This area also provides a way
for users to update passwords.
The VISITS help desk is a mechanism for users to
view and post questions, concerns, changes, and
so forth concerning the application. Since
VISITS is to be accessed by facilities 24-7, this
provides a way for individuals to get answers
when live support is not available
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VISITS Message Center
VISITS Messaging Center
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Click to View Announcement
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Click to Close Announcement
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Click to View Message
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Click to Close Message
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Click icon to download a document.
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Example of a Downloaded Document Security
Agreement
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Click to Update Your User Information
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After You Enter Your New User Information, Click
to Close.
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Click to View Help Desk Topic Example FAQs
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Help Desk FAQ Screen
Click Subject to View Question and Answer
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Help Desk FAQ Screen Example of Question Answer
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Hospital Users Click Here to Enter Data Specific
to Program 1. Hearing Screening 2. Hearing
Follow Up 3. VaCARES (Birth Defects Registry) 4.
At-Risk (For Development Delay, Part C)
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After Clicking Hospital Module, this Screen
Loading pop-up window appears. After a few
seconds, this window will disappear and the
Hospital Module will appear on the screen (next
slide)
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VISITSUser Switchboard
The user switchboard graphically displays all of
the components users have access under the User
Module.
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VISITSUser Switchboard
Directs users to the New client Wizard.
Directs users to a list of reports that can be
generated for their institution.
Directs users to a previously entered client's
record for review, modification, or addition.
Directs users to a data entry screen for entering
totals for the Newborn Hearing screen program.
Directs users to a list of referral and early
intervention centers based on the city/location
chosen from a drop down list.
Directs user to a location where they can search,
locate, edit or add physician information.
Exits the user from the Hospital module and
directs them to the VISITS Messaging Center.
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Hospital Module Main Menu
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VISITSModifying Client Information
To modify client information, users must first
search for the client based on specific search
criteria.
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VISITSModifying Client Information
Once search option(s) are chosen, the user
specifies the search specific search criteria.
In this case a search by a specific last name has
been designated.
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VISITSModifying Client Information
Based on the criteria provided and its presence
in the database, a listing of all matching
clients are listed for viewing. To further
examine a client's record, the user only has to
click on the clients name and the user is
forwarded to that specific record. All users do
not have access to all records. If a user is not
registered at a facility where a client was born,
screened, or designated as transferred to by the
the birth hospital, they will blocked for
accessing a clients record. In these cases, a
facility will have to ask for temporary access to
a clients record from a VISITS administrator.
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VISITSScreening Summary
The screening summary area gives a snapshot of a
clients history. It is also the location for
users to select new screening.
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VISITSScreening Information
On the screening form, information specific to
that screening is entered by the user.
Information is entered through direct user input,
drop downs menus, and pre-filled/unalterable
data. Those fields that have been designated as
Required are shown in red.
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VISITSScreening Information
Diagnosis information is entered by typing the
code in the field. If the code is valid, a
description will appear in the field to the
right. If the code is not valid, the phrase No
description assignedappears.
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VISITS Summary Screen
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Enter Birth Defect Registry Data -- Top of Screen
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Enter Birth Defect Registry Data - Bottom of
Screen
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VISITSAdministrator Switchboard
The Administrator switchboard graphically
displays all of the components administrators
have access under the Administrator Module.
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VISITSAdministrator Switchboard
Directs administrators to a location where they
can search, locate, edit or add physician
information.
Directs administrators to a list of referral and
early intervention centers based on the
city/location chosen from a drop down list.
Also, it also allows administrators to add,
delete, or modify facility information.
Directs administrators to a list of posted
announcements. In this area, individuals may
add, delete, or modify announcement information
Directs administrators to a list of records that
have been assigned temporary access for a
designated facility. Administrators can grant
access, delete access, or change the date that
temporary access expires.
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VISITSAdministrator Switchboard
Directs administrators to a list of hospitals
based on the city/location chosen from a
drop-down list. Also, it allows administrators
to add, delete, or modify hospital information.
Directs administrators to a data entry screen for
entering totals for the Virginia Early Hearing
Detection and Intervention Program.
Directs administrators to a list of registered
users based on a hospital/location chosen in the
drop down list. Administrators are able to add,
delete, and modify user information. They are
able to define whether a user is an administrator
a generic user.
Exits the administrator from the admin. module
and directs them to the VISITS Messaging Center.
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Administrator Module
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Reporting Module Birth Defects Registry --
Reports
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Contact Information

• Nancy Ford, MPH, RN
• Director, Pediatric Screening and Genetic
  Services
• Virginia Department of Health
• 109 Governor St., 8th Fl.
• Richmond, VA 23219
• 804-864-7691
• nancy.ford_at_vdh.virginia.gov
• www.vahealth.org/psgs

• Charles Sutelan, MA, MHA
• Chief Executive Officer
• Welligent, LLC
• 354 West Freemason Street
• Suite 200
• Norfolk, VA 23510
• 757-668-6428
• csutelan_at_chkd.com
• www.visits.org