Tip Sheet: Reporting a Perinatal Hepatitis B Event using MAVEN The MDPH Perinatal Program investigates: All positive hepatitis B labs on women between the ages of 14-44 to determine pregnancy status. MDPH will contact the physician who ordered the lab tests. All deliveries of babies (identified via Newborn Screening [NBS] or reported via teleform) born to women who are positive for hepatitis B. The LBOH investigates: The expectation is that LBOH conduct a contact investigation for family/household/close contacts and sexual contacts to the hepatitis B positive pregnant woman. Notification via phone call and a MAVEN task When a hepatitis B positive woman becomes pregnant or delivers her child, the MDPH Perinatal Program Case Manager will notify the LBOH via a task and a phone call where the woman currently resides by creating an assignment (i.e., creating a task) using the Task Icon on the MAVEN dashboard. The task will indicate that a contact investigation needs to be undertaken. Task Description: Hep B contact investigation needed Notes: Hep B contact investigation needed on pregnant mom for household/family contacts Assign to User select an Individual user Assign to Group do not assign to LBOH Groups v.2014 1
The MAVEN system will generate an email to the contact at the LBOH similar to the sample email shown below: From: ISISHelp@state.ma.us Sent: Date and Time To: Name at BOH The maven task "Hep B contact investigation needed" was updated on Sat Aug 13 10:29:06 MST 2014 by Scott Troppy for Event ID 100010308. Please http://mass.gov/vg to review the changes. Upon initial notification from MDPH that the task Hep B Contact Investigation is required, the LBOH nurse or health agent should immediately acknowledge receipt of this assignment by updating the original task by clicking on the task tab from the main dashboard. >> Click on the "Update Task" button and change status from Pending' to In Progress. The MAVEN system will generate an email back to the Perinatal Case Manager that the task was updated for this event. This communicates back to MDPH that the LBOH nurse or health agent has received this task assignment and will begin work on it. v.2014 2
Case Report Data Collection in MAVEN The LBOH nurse or health agent will collect data located on the "MDPH Case Report Form Supplement #2 Hepatitis B in Pregnant Women", including information on sexual and household contacts, and will enter contact data into MAVEN. (NOTE: This form does not need to be completed and mailed to DPH, provided the information has been entered into MAVEN.) The information on the first page of this form (name, date of birth, Hepatitis B status, and address) will most likely already be entered into MAVEN in the Hepatitis B (Pregnant Women) Question Package #8 that can be seen in the illustration below. v.2014 3
NOTE: When entering vaccine information, for the third dose of Hepatitis B vaccine to be valid it must be given > 8 weeks after 2 nd dose, > 16 weeks after 1 st dose and after 6 months of age. Creating Contacts and Linking Events Once the investigation has been conducted, contacts (e.g., household contacts and sexual contacts) who may have been exposed can be entered into MAVEN to ensure that appropriate steps are taken to prevent continued spread of disease. Begin by clicking on the "Linked Events/Contacts" icon on the dashboard: This should bring you to the Linked Events window show below: In the "Operation" drop-down menu at the top, you must first choose how you are going to link the events. There are three choices for creating contacts. v.2014 4
1. If you choose "Link to Existing Event", you will be creating a link between the current event and an existing event already in the MAVEN system. 2. "Link to Multiple Events" allows you to choose multiple events from the search screen allowing faster creation of linked events than by doing them one by one. 3. Choose "Create Linked Event" if you will be entering a brand new event to link to the index case. Also note that there are several possible link types in the "Link Type" menu in the 4th field; if you are not certain of the link type then leave the contact type defaulted to "contact." Scenario #1 - Linking to an Existing Event >> For this example, select "Link to Existing Event" this means you want to link the event to an existing event that is already in the MAVEN system. Much of the menu will disappear. To find the linked event, you will have to click on the grey button to the right that says "Select Person" and search for the existing event. Once you see the event you have searched for click on it, and then at the bottom of the page click on the grey button that says "Use Selected Event". >> Click on "Use Selected Event". MAVEN will automatically fill in the disease, event date, link type, and information from the existing event. >> Click on "Save" button at the bottom of the screen Scenario #2 - Linking to Multiple Events Already in MAVEN This just enables you to choose multiple contact/link events from the search screen, allowing faster creation of linked events than by doing them one by one. Scenario #3 - Creating a New Contact Event (contact is not yet in MAVEN) >> Select "Create Linked Event" from the Operation drop down choices this means your contact is not in the MAVEN system and you need to enter a new event from scratch. When you create a linked event, the "Disease" field should default to Hepatitis B, so you do not need to change this. The "Event Date" for entry of a contact is the current date, i.e. the date that the contact is entered. v.2014 5
Link Types: If the contact lives in the same household as the initial case, select "household contact:" as the link type. If the contact is a sexual contact of the case, select "sexual contact" as the link type. If the contact is both a sexual and household contact, use "sexual contact" as the link type. For each contact that is created the LBOH nurse should try to ascertain the contact's vaccination history, including the type and date of vaccination, and this information should be entered into MAVEN. >> Enter the name, birth date, and address information for the new linked case, just as you did earlier when creating an event. >> Click "Save" at the bottom of the screen. The new event will appear under the listing for linked events at the top of the screen with the link type listed as Contact (look to the right upper screen) >> Click on the Event ID link next to the person name for your contact event. You will be brought to the main screen, with the new linked case open. Under the "Event Summary", you will see a line for "Linked Events/Contacts." v.2014 6
>> Click on the "View" hyperlink to the right of the "Linked Events/Contacts" line. You will be returned to the linked events page for this event; the original event will be listed under the "Linked Events" heading. Because it was the first event entered and the other event was created as a link to it, under "Link Type" this event is listed as the source. By clicking on the Event ID link for the original event, you can open this event in the main screen. In this way, you can easily toggle back and forth between linked events/cases in MAVEN. v.2014 7
Completing a Contact Investigation When the contact investigation is complete and all contacts have been created and linked to the source case (your pregnant mom), the PHN nurse or health agent should then update the original task to reflect Complete by clicking on the task tab from the main dashboard. >> Click on the "Update Task" button and change status from In Progress to Completed. The MAVEN system will generate an email back to the Perinatal Case Manager that the task was updated for this event. Lastly, once all specified Question Package variables are answered, you tell MDPH through MAVEN that the contact case report form is complete by completing the six steps just like you do for all events in MAVEN. For any questions regarding Perinatal Hepatitis B events/cases please contact Mary Conant-Cantor at MDPH 617-983-6862 or the ISIS help desk at 617-983-6801 v.2014 8