Public Health Briefs 7. Altman DG, Foster V, Rasenick-Douss L, Tye JB. Reducing the illegal sale of cigarettes to minors. JAM4. 1989;261:80-83. 8. Altman DG, Rasenick-Douss L, Foster V, Tye JB. Sustained effects of an educational program to reduce sales of cigarettes to minors. Am J Public Health. 1991;81:891893.
....................................................................................................................................................................................... X
...
9. Skretny MT, Cummings KM, Sciandra R, Marshall J. An intervention to reduce the sale of cigarettes to minors. NY State J MeiL 1990;90:54-55. 10. Tobacco Institute. Major new initiative to discourage youth smoking announced. Press Release. Washington, DC; December 11, 1990.
11. DiFranzaJR. Untitled article. TobaccoAccess Law News. 1990;2:1-2. 12. Godshall WT. Blaming victimized children. SmokeFree Pennsylvania Report. 1991;1(1):20-21. 13. DuMelle F. Industry drive to cut youths' smoking is doublespeak. Washington Tunes. July 23, 1991.
PHLIS: An Electronic System for Reporting Public Health Data from Remote Sites Nany Hargrett Bean, PhD, Stanley Monis Martin MS, and Henry Bradfor4 Jr., PhD
Inrtdudion
.............
.............................
..........................
................................
--------------------
..................................X
........... ............
Disease surveillance conducted by the Centers for Disease Control (CDC) with state health departments provides databases that record disease information and data for special studies. These databases provide information to public health workers throughout the United States and other countries. While demand for data is great, utility is limited by the lag time from disease onset until the record is available for analysis. A personal computer-based reporting system was needed for local, county, or state organizations to enter, edit, and analyz data at their own sites and transmit data electronically to other state and federal offices. Although systems exist to address the needs of a single program, a broader system that could be installed in any site (including international), incorporate the needs of divergent organizations, and handle multiple data types was essential. Therefore, we developed the Public Health Laboratory Information System (PHLIS), a flexible system that captures any type of information (e.g., epidemiologic, laboratory, special studies, surveys) from multiple sources (e.g., hospitals, laboratories, state or county offices) and accommodates data transmission regardless of dissimilarities between computer hardware and software at sending and receiving sites. Several innovative features were designed into PHLIS, for example, a modular approach. Each CDC program responsible for data collection designs and controls each module (a data set containing records concerning a specific pathogen, survey, special study, etc.) in con-
junctionwith state programs. Modules are independent; each can have a unique design (e.g., data entry screen, frequency of data transmission, destination hardware to receive data [personal computer, mainframe, local network, etc.], additional module functions, and analysis and dispersal of data). A decision to change a module does not affect other modules and is limited only by available resources within a program. Of these features, control and analysis of data are critical. The input of expertise at CDC is maximized by having all programs evaluate and disseminate their data to constituents. This is in contrast to systems that collect, maintain, and evaluate data from multiple sources in one central location. Since CDC collects diverse data for many purposes, it is difficult for any single organization to maintain expertise in all areas.
Nancy Hargrett Bean and Stanley Morris Martin are with the Biostatistics and Infornation Management Branch, Division of Bacterial and Mycotic Diseases, Center for Infectious Diseases, Atlanta, Ga. Hemy Bradford, Jr, is with the Louisiana Public Health Laboratory, New Orleans. Requests for reprints should be sent to Nancy Hargrett Bean, PhD, Chief, Surveillance & Epidemic Investigation Section, Division of Bacterial and Mycotic Diseases, Centers for Disease Control, C09, 1600 Clifton Rd, Atlanta, GA 30333. This paper was submitted to the Journal August 2, 1991, and accepted with revisions March 10, 1992.
American Journal of Public Health 1273
Public Health Briefs
Methods 10260O0
Public Health L atoy Inforation System PH LIS
PIUSPC v. 1.1
BROWSE m
,,,,
ANALYZE
BACKUP/RESTOE
CHANGESDELETIONS
14:45:26
TELECOMMUNICATIONS
PRINT ECORDS
Add records to current file
Results
FIGURE 1-DATA ENTRY an ADDMONS opions on the PHUS meu.
FIGURE 2-Salmonella module for data entry on the PHUS systen.
~~Public Health LaoaoyInformation System
PHUSK
PHLIS
v. 1.1
10/26/9 14:46:34
BROWSE ANALYZE BACKUP/RtRE TELECOMMUNIATON
I
_
CHANGES/DELETIONS
PNT RECORDS
Seect Human/Nonhuman
FIGURE 3-Exale of an embedded pick list s
Isdates mdule.
1274 American Journal of Public Health
The Dision of Bacterial and Mycotic Diseases, CDC, the Association of State and Territorial Public Health Laboratory Directors, and medical epidemiologists determined which features should be included to meet the needs of potential users. Seven states (Louisiana, New Mexico, Connecticut, Tennessee, Colorado, Delaware, and Maryland) implemented PHLIS using the Sabnonella surveillance1 system as the pilot module. Pilot state officials installed and implemented PHLIS with only telephone consultations; no visits to sites by CDCwere necessary, and state officials did not travel to CDC for taiing.
n of the Sbahuonell human
Designed for easy installation and operation, PHLIS requires only a personal computer with DOS2 3.0 or higher, a hard disk, atleast512kilobytesofmemory, and a modem. Software for menus provides explicit prompts throughout the system, making PHLIS completely menu driven. PROCOMM PLUS3 telecommunications software was purchased for participating states. The programs were written using Clippet and Epi Info.5 To enter data onto PHLIS select DATAENTRY, ADDITIONS (Figure 1), and the module (e.g., SALMONELLA). Multiple embedded pick lists are available (e.g., after selection of SALMONELLA [Figure 2], an additional list offers human and nonhuman options [Figure 3]). If Salmonella human isolates are selected, the data entry screen for Salmonella human isolates appears (Figure 4). During data entry, the system inhibits input when an error occurs. For example, the serotype is checked for spelling against a list of 1780 serotypes provided in the Salnonella module. Other edit features such as range checks and conditional jumps are included. As a new record is entered, PHLIS assigns a permanent identification number and writes the record to a master file. Transaction files are records not yet sent to other sites, including changes, deletions, and additions. PHLIS recognizes which records have been sent to other sites so that users are not burdened with record tracking. PHLIS adds FIPS county and state codes onto each record as it is entered onto the system. To change a record, select DATA ENTRY, CHANGES/DELETIONS, a module, and a descriptor (e.g., name). The selected record appears and the user
September 1992, Vol. 82, No. 9
Public Health Briefs makes corrections, which are applied to the master file. Corrections and deletions are sent to all receiving sites, including CDC. The BROWSE option provides a way to view but not modify data. Analysis functions are provided by selecting ANALYZE (Figure 5), a procedure (e.g., LIST VARIABLES), and a module. A listing of module-speciflc variable names is displayed (Figure 6), eliminating the need to remember variable names. Users are prompted at all steps, enabling novices to perform simple analyses. All Epi Info analysis options are available by selecting OTHER EPI ANALYSIS. When BACKLUP is selected, PHLIS calculates the number of diskettes necessaxy and allows the user to format additional diskettes. Archived data can be restored by selecting RESTORE, choosing a module, and inserting the archive diskette. A pyramid structure ofdata transmission can be developed within states. For example, data initiating locally could be sent to a county or state office and finally to CDC. Alternatively, data can be simultaneously transmitted to state offices and CDC. States retain control over established procedures for data flow, evaluation, and release. The number of participants in a state is not limited, and multiple sites can upload data concurrently. PHLIS provides several formats for sending data to other sites by specifying the file type (Epi Info, dBASE,6 ASCII) to be written. Furthermore, if states currently have other types of data systems (e.g., Paradox or VAX), files (ASCII, Epi Info, or dBASE) may be imported into PHLIS in a prescribed format. For example, PHLIS is currently receiving data from two states with VAX systems. Therefore, PHLIS data can be accessed by other software and can incorporate data from other systems. Data are received via a personal computer dedicated to communications. Selecting SEND TO CDC (Figure 7) and a module causes PHLIS to call the communications computer, log the user on with appropriate identification, upload the data, indicate whether data have been transferred correctly, and log off. No experience is needed with telecommunications to accomplish transfer of data electronically. Data may be transmitted as often as necessary (multiple times in the same day if desired). Transmitted data are downloaded to the CDC mainframe, where processing and edits are performed by the responsible program. If errors are detected, edits are transmitted back to reporting sites. MesSeptember 1992, Vol. 82, No. 9
.. d-, p(
MON: _
S5R3aM DATE OR .SIYFE CODE.# OR ectvx,
ALm atrALnIE NAME:
TMi F
:__
LAST NAME
1T
Mood:-w
ognf
a0ielnbr ntesdb tblum
Mr F) SB _Ma
wn) a monh
oru , a
ib apdm) one MaqW 1 bor owcty
bonw.
04 Os 10
07
R.Sr NAME:
eO, A ACiE nin_mon
9 Ci_' ''
hibsg _ibvlis 09o Idn;i 03
SATLUS: # (Cm-1 Cardr-I -link no_'-3)
1
"'oor 0 _ iGn
*sok 9
OOjN1.___,_...
_
_
E__
AGE IN WAR& A 1N Mo
SPEOMEN:
a En p_t a1sna-- m
ATE JJ
_
_
_
DATE 1IQ2EQ90 _5.'.! TOM"S
.
adne:#
a* : .C o''
)
' pspina &i:
sputum: '# Vd- Wl ..
#
'-
..
COMMET:'
FIGURE 4-Salmonell human Isolts data entry screen. sages and tables summarizing data received at CDC are downloaded to sites. The TELECOMMUNICATIONS option (Figure 8) provides access to other CDC systems, and bulletin board script files contain telephone numbers that PHLIS accesses when connecting to other systems. Therefore, PHLIS can connect to additional services as requested by state officials (e.g., E-Mail).
Discussion PHLIS has immediate benefits for public health: (1) Electronic transmission of reports reduces the paper and data en-
try burdens within states (in one state, the same reports of SalmoneUla are routinely entered into three computers and again at CDC). (2) Access to timely national summaries ensures that data are current and responses to inquires at local, state, and CDC levels are timely. (3) PHLIS increases interaction among public health officials, stimulates more thorough reporting, and fosters greater awareness of reporting problems. Finally, rapid reporting provides the potential to quickly identify unusual disease clusters and alert state epidemiologists and CDC personnel to outbreak episodes. However, the need for careful field investigation and data assess-
I PHUVK v.
1P1
M ATAENTRY
10V26/90
PUMIC He~~abortoynfoDmation Sse PHLIS
ROWSE MEANS
BACKUP/RESTORE
FREQUENCIES
TABIES
14:49:30
TELECOMMUNIC4IION OTHER EPI ANALYSIS
Ust selcted variables
FIGURE 5-ANALYZE and UST VARIABLES optons of the PHUS menu.
i
American Journal of Public Health 1275
Public Healh Briefs
Select the variable name from this list: SALMONELIA HUMAN I Field I Variable I Field Name I Length I Length 1 6 STOOL 1 BLOOD 6 1 URINE 6 1 SPUTUM 31 1 SPINAL 3 1 ABSCESS 1 1 15 WOUND 1 OTITIS 15 1 THROAT 1 1 GALL 3 AGE 1 BONE 2 MONTHS 1 JOINT 3 COUNTYFIPS 1 OTHER 21 COUNTY 1 UNKNOWN 67 COMMENT spaces: by Enter variable name(s) for listing, separated
Variable Name ID TODAY SPECDATE SEROTYPE PHAGE STATUS LASTNAME FIRSTNAME SEX
FIGURE Varable name for the Salmonella human lsoates module.
Public Heailh Laboatory Information System
CPll9x
PHLIS
v. 1.1
CI4TA ENTRY
BROWSE
ANALYZE
BACKUP/RESTORE SEND TO STATE
PFEPRES -DATA
1026/90 14:51:05 BULElIN BOARD
ment prior to data entry remains the responsibility of the originating site. PHLIS can be implemented without the telecommunications components; data can be transferred as ASCII files via modems among sites without a central computer to receive data; and organizations without modems can transmit data via diskettes without affecting system integrity. PHLIS is currently installed in 41 of the 45 state laboratories that have requested the system. Although the initial PHLIS module was implemented using laboratory-based data, the system accommodates all data types (e.g., epidemiological data). Three additional laboratory modules have been added to the system (Shigella, Campylobacter, and Mycobacteria), as well as one module to collect epidemiological data from state epidemiologists' offices (seafood case-control study). PHLIS was designed to provide flexibilitywith few constraints placed on module design and data transfer. Plans for enhancements include development of an "applications generator" that allows users to develop new modules or make modifications to accommodate unique site needs. PHIIS is available without cost to any organization-wishing to implement the system. ]
Acknowledgents Upklod file to communkations computer.
FIGURE 7-TELECOMMUNICATIONS and SEND TO CDC optons on the PHUS menu.
PLiS v.1.1
Pubic Health Laboratory Infwmation System PHLIS | | | _5ZALYZE
P PAR ATA
SEND TO CDC
14:51:24
BCKUP/RESTORE
References
SEND TO STATE
1. SalmonellaAnnual Swmnmay. Atlanta, Ga: Centers for Disease Control; 1982. 2. IBM Corporation and Microsoft Inc. Disk
Select connection desired
FiGURE 8-BNULLETiN BNOARDS sleton on th PHUS menu.
1276 American Journal of Public Health
1026/90
Portions of this material were presented at the 32nd Annual Planning Conference of the Association of State and Public Health Laboratory Directors, 1989, and the annual meeting of the Council of State and Territorial Epidemiologists, 1990. We thank the Management Information Systems Committee of the Association of State and Territorial Public Health Laboratory Directors for their guidance and support, Sara Lyle for computer programming for PHLIS, and the personnel in the seven pilot states for their participation.
Operating System Version 3.0. IBM Corporation and Microsoft Inc; 1984. 3. Datastorm Technologies Inc. PROCOMM PLUS Intuitive Commwucations. Columbia, Mo: Datastorm Technologies Inc; 1988. 4. Nantucket Corporation. Clipper, Version Summer '87. Los Angeles, Calif: Nantucket Corporation; 1987. 5. Dean AD, Dean JA, Burton JH, Dicker RC. Epi Info, Version3:A Word Processin& Database, and Statistics Program for Epidemioloy for Microcomputers. Atlanta, Ga: Centers for Disease Control; 1988. 6. Ashton-Tate. dBASE IH Plus. Torrance, Calif: Ashton-Tate; 1986.
September 1992, Vol. 82, No. 9
....................................................................................................................................................................................... X
...
9. Skretny MT, Cummings KM, Sciandra R, Marshall J. An intervention to reduce the sale of cigarettes to minors. NY State J MeiL 1990;90:54-55. 10. Tobacco Institute. Major new initiative to discourage youth smoking announced. Press Release. Washington, DC; December 11, 1990.
11. DiFranzaJR. Untitled article. TobaccoAccess Law News. 1990;2:1-2. 12. Godshall WT. Blaming victimized children. SmokeFree Pennsylvania Report. 1991;1(1):20-21. 13. DuMelle F. Industry drive to cut youths' smoking is doublespeak. Washington Tunes. July 23, 1991.
PHLIS: An Electronic System for Reporting Public Health Data from Remote Sites Nany Hargrett Bean, PhD, Stanley Monis Martin MS, and Henry Bradfor4 Jr., PhD
Inrtdudion
.............
.............................
..........................
................................
--------------------
..................................X
........... ............
Disease surveillance conducted by the Centers for Disease Control (CDC) with state health departments provides databases that record disease information and data for special studies. These databases provide information to public health workers throughout the United States and other countries. While demand for data is great, utility is limited by the lag time from disease onset until the record is available for analysis. A personal computer-based reporting system was needed for local, county, or state organizations to enter, edit, and analyz data at their own sites and transmit data electronically to other state and federal offices. Although systems exist to address the needs of a single program, a broader system that could be installed in any site (including international), incorporate the needs of divergent organizations, and handle multiple data types was essential. Therefore, we developed the Public Health Laboratory Information System (PHLIS), a flexible system that captures any type of information (e.g., epidemiologic, laboratory, special studies, surveys) from multiple sources (e.g., hospitals, laboratories, state or county offices) and accommodates data transmission regardless of dissimilarities between computer hardware and software at sending and receiving sites. Several innovative features were designed into PHLIS, for example, a modular approach. Each CDC program responsible for data collection designs and controls each module (a data set containing records concerning a specific pathogen, survey, special study, etc.) in con-
junctionwith state programs. Modules are independent; each can have a unique design (e.g., data entry screen, frequency of data transmission, destination hardware to receive data [personal computer, mainframe, local network, etc.], additional module functions, and analysis and dispersal of data). A decision to change a module does not affect other modules and is limited only by available resources within a program. Of these features, control and analysis of data are critical. The input of expertise at CDC is maximized by having all programs evaluate and disseminate their data to constituents. This is in contrast to systems that collect, maintain, and evaluate data from multiple sources in one central location. Since CDC collects diverse data for many purposes, it is difficult for any single organization to maintain expertise in all areas.
Nancy Hargrett Bean and Stanley Morris Martin are with the Biostatistics and Infornation Management Branch, Division of Bacterial and Mycotic Diseases, Center for Infectious Diseases, Atlanta, Ga. Hemy Bradford, Jr, is with the Louisiana Public Health Laboratory, New Orleans. Requests for reprints should be sent to Nancy Hargrett Bean, PhD, Chief, Surveillance & Epidemic Investigation Section, Division of Bacterial and Mycotic Diseases, Centers for Disease Control, C09, 1600 Clifton Rd, Atlanta, GA 30333. This paper was submitted to the Journal August 2, 1991, and accepted with revisions March 10, 1992.
American Journal of Public Health 1273
Public Health Briefs
Methods 10260O0
Public Health L atoy Inforation System PH LIS
PIUSPC v. 1.1
BROWSE m
,,,,
ANALYZE
BACKUP/RESTOE
CHANGESDELETIONS
14:45:26
TELECOMMUNICATIONS
PRINT ECORDS
Add records to current file
Results
FIGURE 1-DATA ENTRY an ADDMONS opions on the PHUS meu.
FIGURE 2-Salmonella module for data entry on the PHUS systen.
~~Public Health LaoaoyInformation System
PHUSK
PHLIS
v. 1.1
10/26/9 14:46:34
BROWSE ANALYZE BACKUP/RtRE TELECOMMUNIATON
I
_
CHANGES/DELETIONS
PNT RECORDS
Seect Human/Nonhuman
FIGURE 3-Exale of an embedded pick list s
Isdates mdule.
1274 American Journal of Public Health
The Dision of Bacterial and Mycotic Diseases, CDC, the Association of State and Territorial Public Health Laboratory Directors, and medical epidemiologists determined which features should be included to meet the needs of potential users. Seven states (Louisiana, New Mexico, Connecticut, Tennessee, Colorado, Delaware, and Maryland) implemented PHLIS using the Sabnonella surveillance1 system as the pilot module. Pilot state officials installed and implemented PHLIS with only telephone consultations; no visits to sites by CDCwere necessary, and state officials did not travel to CDC for taiing.
n of the Sbahuonell human
Designed for easy installation and operation, PHLIS requires only a personal computer with DOS2 3.0 or higher, a hard disk, atleast512kilobytesofmemory, and a modem. Software for menus provides explicit prompts throughout the system, making PHLIS completely menu driven. PROCOMM PLUS3 telecommunications software was purchased for participating states. The programs were written using Clippet and Epi Info.5 To enter data onto PHLIS select DATAENTRY, ADDITIONS (Figure 1), and the module (e.g., SALMONELLA). Multiple embedded pick lists are available (e.g., after selection of SALMONELLA [Figure 2], an additional list offers human and nonhuman options [Figure 3]). If Salmonella human isolates are selected, the data entry screen for Salmonella human isolates appears (Figure 4). During data entry, the system inhibits input when an error occurs. For example, the serotype is checked for spelling against a list of 1780 serotypes provided in the Salnonella module. Other edit features such as range checks and conditional jumps are included. As a new record is entered, PHLIS assigns a permanent identification number and writes the record to a master file. Transaction files are records not yet sent to other sites, including changes, deletions, and additions. PHLIS recognizes which records have been sent to other sites so that users are not burdened with record tracking. PHLIS adds FIPS county and state codes onto each record as it is entered onto the system. To change a record, select DATA ENTRY, CHANGES/DELETIONS, a module, and a descriptor (e.g., name). The selected record appears and the user
September 1992, Vol. 82, No. 9
Public Health Briefs makes corrections, which are applied to the master file. Corrections and deletions are sent to all receiving sites, including CDC. The BROWSE option provides a way to view but not modify data. Analysis functions are provided by selecting ANALYZE (Figure 5), a procedure (e.g., LIST VARIABLES), and a module. A listing of module-speciflc variable names is displayed (Figure 6), eliminating the need to remember variable names. Users are prompted at all steps, enabling novices to perform simple analyses. All Epi Info analysis options are available by selecting OTHER EPI ANALYSIS. When BACKLUP is selected, PHLIS calculates the number of diskettes necessaxy and allows the user to format additional diskettes. Archived data can be restored by selecting RESTORE, choosing a module, and inserting the archive diskette. A pyramid structure ofdata transmission can be developed within states. For example, data initiating locally could be sent to a county or state office and finally to CDC. Alternatively, data can be simultaneously transmitted to state offices and CDC. States retain control over established procedures for data flow, evaluation, and release. The number of participants in a state is not limited, and multiple sites can upload data concurrently. PHLIS provides several formats for sending data to other sites by specifying the file type (Epi Info, dBASE,6 ASCII) to be written. Furthermore, if states currently have other types of data systems (e.g., Paradox or VAX), files (ASCII, Epi Info, or dBASE) may be imported into PHLIS in a prescribed format. For example, PHLIS is currently receiving data from two states with VAX systems. Therefore, PHLIS data can be accessed by other software and can incorporate data from other systems. Data are received via a personal computer dedicated to communications. Selecting SEND TO CDC (Figure 7) and a module causes PHLIS to call the communications computer, log the user on with appropriate identification, upload the data, indicate whether data have been transferred correctly, and log off. No experience is needed with telecommunications to accomplish transfer of data electronically. Data may be transmitted as often as necessary (multiple times in the same day if desired). Transmitted data are downloaded to the CDC mainframe, where processing and edits are performed by the responsible program. If errors are detected, edits are transmitted back to reporting sites. MesSeptember 1992, Vol. 82, No. 9
.. d-, p(
MON: _
S5R3aM DATE OR .SIYFE CODE.# OR ectvx,
ALm atrALnIE NAME:
TMi F
:__
LAST NAME
1T
Mood:-w
ognf
a0ielnbr ntesdb tblum
Mr F) SB _Ma
wn) a monh
oru , a
ib apdm) one MaqW 1 bor owcty
bonw.
04 Os 10
07
R.Sr NAME:
eO, A ACiE nin_mon
9 Ci_' ''
hibsg _ibvlis 09o Idn;i 03
SATLUS: # (Cm-1 Cardr-I -link no_'-3)
1
"'oor 0 _ iGn
*sok 9
OOjN1.___,_...
_
_
E__
AGE IN WAR& A 1N Mo
SPEOMEN:
a En p_t a1sna-- m
ATE JJ
_
_
_
DATE 1IQ2EQ90 _5.'.! TOM"S
.
adne:#
a* : .C o''
)
' pspina &i:
sputum: '# Vd- Wl ..
#
'-
..
COMMET:'
FIGURE 4-Salmonell human Isolts data entry screen. sages and tables summarizing data received at CDC are downloaded to sites. The TELECOMMUNICATIONS option (Figure 8) provides access to other CDC systems, and bulletin board script files contain telephone numbers that PHLIS accesses when connecting to other systems. Therefore, PHLIS can connect to additional services as requested by state officials (e.g., E-Mail).
Discussion PHLIS has immediate benefits for public health: (1) Electronic transmission of reports reduces the paper and data en-
try burdens within states (in one state, the same reports of SalmoneUla are routinely entered into three computers and again at CDC). (2) Access to timely national summaries ensures that data are current and responses to inquires at local, state, and CDC levels are timely. (3) PHLIS increases interaction among public health officials, stimulates more thorough reporting, and fosters greater awareness of reporting problems. Finally, rapid reporting provides the potential to quickly identify unusual disease clusters and alert state epidemiologists and CDC personnel to outbreak episodes. However, the need for careful field investigation and data assess-
I PHUVK v.
1P1
M ATAENTRY
10V26/90
PUMIC He~~abortoynfoDmation Sse PHLIS
ROWSE MEANS
BACKUP/RESTORE
FREQUENCIES
TABIES
14:49:30
TELECOMMUNIC4IION OTHER EPI ANALYSIS
Ust selcted variables
FIGURE 5-ANALYZE and UST VARIABLES optons of the PHUS menu.
i
American Journal of Public Health 1275
Public Healh Briefs
Select the variable name from this list: SALMONELIA HUMAN I Field I Variable I Field Name I Length I Length 1 6 STOOL 1 BLOOD 6 1 URINE 6 1 SPUTUM 31 1 SPINAL 3 1 ABSCESS 1 1 15 WOUND 1 OTITIS 15 1 THROAT 1 1 GALL 3 AGE 1 BONE 2 MONTHS 1 JOINT 3 COUNTYFIPS 1 OTHER 21 COUNTY 1 UNKNOWN 67 COMMENT spaces: by Enter variable name(s) for listing, separated
Variable Name ID TODAY SPECDATE SEROTYPE PHAGE STATUS LASTNAME FIRSTNAME SEX
FIGURE Varable name for the Salmonella human lsoates module.
Public Heailh Laboatory Information System
CPll9x
PHLIS
v. 1.1
CI4TA ENTRY
BROWSE
ANALYZE
BACKUP/RESTORE SEND TO STATE
PFEPRES -DATA
1026/90 14:51:05 BULElIN BOARD
ment prior to data entry remains the responsibility of the originating site. PHLIS can be implemented without the telecommunications components; data can be transferred as ASCII files via modems among sites without a central computer to receive data; and organizations without modems can transmit data via diskettes without affecting system integrity. PHLIS is currently installed in 41 of the 45 state laboratories that have requested the system. Although the initial PHLIS module was implemented using laboratory-based data, the system accommodates all data types (e.g., epidemiological data). Three additional laboratory modules have been added to the system (Shigella, Campylobacter, and Mycobacteria), as well as one module to collect epidemiological data from state epidemiologists' offices (seafood case-control study). PHLIS was designed to provide flexibilitywith few constraints placed on module design and data transfer. Plans for enhancements include development of an "applications generator" that allows users to develop new modules or make modifications to accommodate unique site needs. PHIIS is available without cost to any organization-wishing to implement the system. ]
Acknowledgents Upklod file to communkations computer.
FIGURE 7-TELECOMMUNICATIONS and SEND TO CDC optons on the PHUS menu.
PLiS v.1.1
Pubic Health Laboratory Infwmation System PHLIS | | | _5ZALYZE
P PAR ATA
SEND TO CDC
14:51:24
BCKUP/RESTORE
References
SEND TO STATE
1. SalmonellaAnnual Swmnmay. Atlanta, Ga: Centers for Disease Control; 1982. 2. IBM Corporation and Microsoft Inc. Disk
Select connection desired
FiGURE 8-BNULLETiN BNOARDS sleton on th PHUS menu.
1276 American Journal of Public Health
1026/90
Portions of this material were presented at the 32nd Annual Planning Conference of the Association of State and Public Health Laboratory Directors, 1989, and the annual meeting of the Council of State and Territorial Epidemiologists, 1990. We thank the Management Information Systems Committee of the Association of State and Territorial Public Health Laboratory Directors for their guidance and support, Sara Lyle for computer programming for PHLIS, and the personnel in the seven pilot states for their participation.
Operating System Version 3.0. IBM Corporation and Microsoft Inc; 1984. 3. Datastorm Technologies Inc. PROCOMM PLUS Intuitive Commwucations. Columbia, Mo: Datastorm Technologies Inc; 1988. 4. Nantucket Corporation. Clipper, Version Summer '87. Los Angeles, Calif: Nantucket Corporation; 1987. 5. Dean AD, Dean JA, Burton JH, Dicker RC. Epi Info, Version3:A Word Processin& Database, and Statistics Program for Epidemioloy for Microcomputers. Atlanta, Ga: Centers for Disease Control; 1988. 6. Ashton-Tate. dBASE IH Plus. Torrance, Calif: Ashton-Tate; 1986.
September 1992, Vol. 82, No. 9
