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Table 3 Major themes with frequencies of sub-themes coded in clinic reporter (n = 11) and PHA worker (n = 9) interviews

From: Notifiable condition reporting practices: implications for public health agency participation in a health information exchange

 

Clinics

n (%)

PHAs

n (%)

Theme 1: Greater reporting knowledge and experience is associated with perceptions of a minimal reporting burden

Sub-themes:

Notifiable condition reporting is not a burden or time-consuming activity or interruptive of daily workflow for regular reporters

7 (63.6)

-

Reporting requirements (who should report, which conditions are reportable, which forms to use, reporting timeframes for different conditions) are clear for regular reporters

7 (63.6)

-

Clinic settings in which regular reporters work have a well-established flow of information and process for handling new positive cases of reportable conditions

7 (63.6)

-

Infrequent reporters perceive notifiable condition reporting as burdensome and interruptive of their workflow

4 (36.4)

-

Reporting requirements are not clear for infrequent reporters

4 (36.4)

-

Infrequent reporters assume that labs report notifiable conditions

4 (36.4)

-

Infrequent reporters express confusion about whether their organization requires notifiable condition reporting

4 (36.4)

-

Theme 2: A positive laboratory report initiates the case reporting process in both clinic and PHA settings

Sub-themes:

Reporting workflow in begins with receipt of a positive lab result in both clinics and PHAs

11 (100)

9 (100)

PHA workers begin case processing activities with receipt of a positive lab result

-

9 (100)

Other than treatment orders based on a lab report, physicians are not involved reporting workflow

11 (100)

 

Lab reports are missing critical information, such as clinic name, patient phone number, etc., so are insufficient alone for case reporting

-

9 (100)

Delays in lab reporting contribute to delayed CDR form completion

3 (27.3)

 

Theme 3: Inaccurate or missing information interrupts and delays reporting which contributes to timeliness, data quality and completeness issues

Sub-themes:

PHA workers perceive the majority of CDR forms they receive as generally incomplete, missing crucial information and low in data quality

-

9 (100)

PHA workers report frequent communications with clinics to gather needed case information

-

9 (100)

PHA workers perceive that communications with clinics around reporting can be unproductive and frustrating

-

9 (100)

Clinics are perceived as infrequent reporters due to their assumption that labs report to PHAs

-

9 (100)

Specific to communications around notifiable condition reporting, clinic reporters perceive frequency of contact from PHAs as rare

8 (72.7)

-

Inaccurate or missing contact information prevents reaching patients regarding treatment

6 (54.5)

9 (100)

Clinic reporters assume labs report so do not regularly submit CDR forms

4 (36.4)

-

Clinic reporters are unaware that they are required to submit CDR forms

4 (36.4)

-

Clinic reporters knowingly submit CDR forms with missing information

3 (27.3)

-

Clinic reporters only complete CDR form fields that they deem pertinent

2 (18.2)

-

Theme 4: Searching for needed information interrupts and delays reporting and case investigation workflow

Sub-themes:

Numerous and varied information resources are utilized to complete CDR forms, conduct investigations and/or close cases

9 (81.8)

9 (100)

Clinic reporters spend time looking for, waiting for and compiling information from various sources (EHRs, different reporting and/or clinical systems, chart notes, lab reports, online searches, etc.)

7 (63.6)

-

PHA workers spend a majority of their time looking for and compiling information from various sources to conduct case processing

-

9 (100)

Theme 5: PHAs cannot be certain that the clinical advisories, updates and information they send are reaching their target audience

Sub-themes:

Clinic reporters do not have a clear idea about how information such as CDR form data is used by PHAs

8 (72.7)

-

Announcements and information sent by PHAs (fax, email) are not routinely distributed throughout the clinic

5 (45.5)

-

Some clinics report they never receive announcements or information from PHAs

4 (36.4)

-

Only PHA information deemed relevant is disseminated but how that determination is made is unclear to recipients

3 (27.3)

-