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The Wisconsin EHDI Tracking Referral and Coordination System. March 4, 2005 Elizabeth Seeliger, Lilah Katcher Wisconsin Department of Health and Family Services. Welcome to Wisconsin! A few facts to get us started:. Births ~ 69,000/year. Birthing Hospitals = 102.

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The Wisconsin EHDI Tracking Referral and Coordination System

March 4, 2005

Elizabeth Seeliger, Lilah Katcher

Wisconsin Department of Health and Family Services


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Welcome to Wisconsin! A few facts to get us started:

Births ~ 69,000/year

Birthing Hospitals = 102

Population ~ 5.4 million cheeseheads

Home of the Wisconsin Sound Beginnings (WSB) EHDI program and WE-TRAC


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WE-TRAC, the Wisconsin EHDI Tracking Referral and Coordination System,

  • supports the goals of the WSB program and the national EHDI algorithm

  • provides a mechanism for the tracking and reporting of individual, hospital, and statewide aggregate hearing screening data.

  • allows electronic referrals to appropriate organizations, and denotes a clear transfer of responsibility for follow-up activities.

  • acts as a safety net assuring timely and appropriate coordination of care throughout the EHDI continuum.

  • is a part of the Wisconsin Public Health Information Network (WI PHIN)

  • is designed to be compatible with the NEDSS base system

  • has a common interface with other Wisconsin Program Area Modules (PAMs)


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WE-TRAC is a part of the WI PHIN, which

  • Is the portal into applications supporting public health in Wisconsin, including WE-TRAC, West Nile Virus, SPHERE (public health records), and Birth Defects Surveillance PAMs.

  • Hosts a centralized directory of users and organizations

  • Brings together:

    • The WI Health Alert Network (HAN),

    • PAMs

    • Wisconsin State Lab of Hygiene (SLH) Electronic Laboratory Reporting, and

    • The NEDSS base system.

  • Will be the platform for integrated public health data in Wisconsin


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WE-TRAC uses data collected on the SLH newborn blood card.

  • Hearing screening data added to the blood card beginning April 30, 2002.

  • SLH staff does initial follow-up on missing blood card information


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WE-TRAC hearing screening data is entered at the SLH.

  • Blood card data used by WE-TRAC is sent from the SLH by secure messaging to the WE-TRAC server at the University of Wisconsin Division of Information Technology (UW-DoIT)

  • Records with complete hearing screening information are sent nightly

  • Records with incomplete hearing screening information are held for up to 10 days for more information from the blood card hearing screening “pullout”

  • Records for babies passing the hearing screening are archived in WE-TRAC

  • Babies who refer or were not screened are placed in the WE-TRAC birth hospital “queue” for follow-up

  • At this point, only the birth hospital can view or manage records for babies born at their organization


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WE-TRAC “queues” ensure secure case management.

WE-TRAC Queue and Case Management Options (Birthing Unit)


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WE-TRAC also uses role-based security to restrict access.

  • Three roles: User, Local Administrator, WE-TRAC Administrator:

  • Users can view site news, modify their individual profile and preference information, view records and manage care for babies associated with their organization, manage hearing-related care of these babies, and enter other information about the baby.

  • Local Administrators can, in addition, modify organization profile, modify organization preferences, manage organization user information and roles, and approve or reject requests for secondary authorization to the organization.

  • WE-TRAC Administrators can, in addition manage site news, site forms, role-based system access, and and user feedback; create, manage, and “map” organizations; manage cases needing additional followup.


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WE-TRAC users must obtain a WAMS ID and register for the WI HAN.

  • The State of Wisconsin's Web Access Management System provides a single user ID for user authentication to all state sites for which the user has authorization.

  • The HAN stores user information in a central directory and gives users an option to select public health alert notifications.

WE-TRAC Login Screen Detail


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WE-TRAC is a workflow system that allows hearing care coordination.

  • WE-TRAC recently completed a 1 year pilot, and has 25 active user organizations. Almost 25% of WI births occur at WE-TRAC hospitals.

  • WE-TRAC allows entry of sequential events along the EHDI continuum.

  • A common intuitive interface is shared by nursery staff, NICU staff, primary care physicians, audiologists, and Birth to Three providers.

  • Based on pilot feedback, we developed additional workflow elements to support tracking of NICU babies--transfers and inpatient screening entry

  • Electronic referrals denote clear transfers of responsibility.

  • Organizations have “look-back, look-ahead” capability to see the status of a baby for which they have provided care

  • Users can monitor that timely and appropriate hearing-related care is provided to all babies associated with their organization


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WE-TRAC allows users to enter screening results.

  • NICU organizations can enter repeat inpatient screening results, other organizations enter outpatient re-screening results

WE-TRAC Screening Form


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WE-TRAC allows easy transfers and referrals to follow-up organizations.

WE-TRAC Referral Screen


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WE-TRAC allows entry of diagnostic audiology results.

WE-TRAC Audiology Report


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WE-TRAC allows completion of the Confirmed Hearing Loss form (CHL).

  • The CHL Report is the first place WI collects Risk Factors

  • At this point, audiologists will enter a referral to Early Intervention and, with parental consent, notify others, including the

    • Birth Hospital

    • Guide-By-Your-Side Program

    • and Primary Care Physician

See Handouts


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WE-TRAC supports timely and appropriate hearing follow-up.

  • System prompts guide users to complete the next step (referrals, CHL form) immediately after test results are entered.

WE-TRAC “Last Action, Next Suggested Action” Display


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WE-TRAC “time-outs” promote timely and appropriate care.

  • A next recommended procedure and date appear by each baby’s name in the queue.

  • If the procedure does not occur by the “time-out date,” the baby’s name and the date will turn red.

  • On time-out, an E-mail is sent to providers, and a copy of the baby’s record is placed in the WE-TRAC “timed-out queue” for follow-up.

WE-TRAC Timed-out Queue Item Detail


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PCP/Medical Home

  • Frequent system prompts remind users to enter PCP/Medical Home information.

  • Email notification is sent to the Medical Home upon refusal of care.


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Child’s Chart

Includes:

  • Parent Information

    • adoption (hides birth parent information)

    • foster care (allows addition of guardian information)

  • Hearing screening & follow-up history

  • Address and Medical Home information

  • Blood Card Information

    • Includes graphic representation

See Handout


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WE-TRAC Future Directions

  • Continue integration with the PHIN, PAMS and NEDSS base system

  • Continue outreach and training--bringing more organizations onto the system. Develop training video that can be accessed from WE-TRAC.

  • Conduct PCP focus groups co-facilitated by the EHDI WI- Chapter Champion to further define physician requirements for WE-TRAC

  • Develop a robust Early Intervention module for use by Birth to Three providers

  • Develop an interface to be used by the Guide-By-Your-Side Program

  • Expand collection of lost-to-follow-up data

  • Continue to develop SAS reporting capabilities


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WSB Contacts

WI CSHCN Toll Free Number 1-800-441-4576

Sharon Fleischfresser, MD, MPH, CSHCN Medical Director [email protected]

Elizabeth Seeliger, MA, CCC-A, WSB Program Coordinator [email protected]

Lilah Katcher, WE-TRAC Project Manager [email protected]


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