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Bulletin: Reviewing Vault Access by Users


Syndromic Surveillance collects a limited data set from participating healthcare facilities.  Under HIPAA, limited datasets do not require the same high security standards for data at rest and data in motion.  With the collection of data beyond Syndromic Surveillance data, which is not part of an evaluated limited data set, there is greater concern regarding handling of PHI and Other Sensitive Information (POSI).

To address this concern regarding proper handling of POSI, Health Monitoring has implemented a new component within EpiCenter (the Vault) and introduced audited access to data which may contain POSI.  EpiCenter users are prompted to enter a POSI Access Reason as well as provide a password verification in order to access reports that include POSI.

Vault Report Access Tracking

Health Monitoring has created a set of three reports that allows the appropriate personnel to see which EpiCenter users, within their region, have accessed the Vault along with their POSI Access Reason.

Each of the three reports serves a different purpose. The “Find Vault Report Usage” report shows each execution of a report per line. The “Find Vault Audit Entries” report shows each retrieval of a piece of sensitive information per line. The “Find Vault Value Entries” report is not listed directly under the Reports menu, as is it a pivot form the “Find Vault Audit Entries” report. This report shows the access history for a particular piece of sensitive information; one access per line (access types can be Create, Read, Write, etc.).

Effective Date

These three reports have been implemented into the Production environment and the appropriate users will be granted access to them.

Bulletin: EpiCenter Browser Support (Internet Explorer 11 End-of-Life)

Health Monitoring continues ongoing support of EpiCenter for the Google Chrome and Microsoft Edge browsers.

As of November 30, 2020, Microsoft has stopped supporting Internet Explorer 11 (IE 11), as noted in the Microsoft announcement1 published on August 17, 2020.  This discontinuation may affect EpiCenter’s stability in IE 11.

Impact on EpiCenter

With Microsoft’s ceased support for IE 11, Health Monitoring Systems cannot guarantee that EpiCenter will be fully functional using the IE 11 web browser after the 3.5.21 EpiCenter Release. Health Monitoring recommends using Google Chrome for EpiCenter.



Bulletin: Date/Time Granularity in Maps, Reports, Quick Charts, and Pivot Charts

This bulletin discusses how time increments are handled in EpiCenter’s Maps tab (e.g., maps and Quick Charts) and in the Reports tab (e.g., in custom report maps and related Pivot Charts).

Users typically select an increment of time (hour, day, week, or month) as the basis for their data analysis. To work with data from a given period, users select the end date they want and then specify an amount of time (in hours, days, weeks, or months) leading up to that date.

In the Maps Tab

For analyzing current data totaled by day, the Maps tab applies the current time of day by default, and defines each day as a 24-hour period ending at that time. The presumption is that the user wishes to see current analysis.

For analyzing historical data that is totaled by day, or for analyzing any data that is totaled by week or month, the Maps tab uses as its time frame the calendar day, week, or month containing the date keyed into the input selector.

A calendar week corresponds to an MMWR week, running from Sunday to Saturday. See https://wwwn.cdc.gov/nndss/document/MMWR_Week_overview.pdf for details.

A calendar month extends from 00:00 on the first day of the month to 23:59 on the last day of the month.

If the “Enable Hours” option is activated, the Maps tab’s input selector will accept hour specifications and apply them when totaling data by hour or day. When data is totaled by week or month, the system will accept hour specifications but will not apply them.

Supported Analysis Methods
  • Exponential Moving Average Probability, Recursive Least Squares Probability, and Simple Moving Average Probability support data totaling by day only.
  • Poisson supports data totaling by hour and day.
  • Total Counts support data totaling by hour, day, week, and month.

In the Reports Tab

For analyzing current data totaled by day, Report maps permit users to specify a time in the input selector; a 24-hour period ending at that time constitutes one day. Hours and minutes may always be specified, and when totaling by day the specified time is always applied.

For analyzing historical data that is totaled by day, or for analyzing any data that is totaled by week or month, Report maps function just like those in the Maps tab.

Week and month definitions remain the same.

In effect, the “Enable Hours” functionality is built into Report maps, in that time specifications are allowed at all times. However, as in the Maps tab, time specifications are only applied when data is totaled by hour or day. When totaling by week or month, the system will accept time specifications but will not apply them.

Supported Analysis Methods
  • Exponential Moving Average Probability, Recursive Least Squares Probability, Cumulative Sum – EMA Probability, Simple Moving Average Probability, and Poisson support data totaling only by day.
  • Total Counts support data totaling by hour, day, week, and month.

In Quick Charts and Pivot Charts

Added historical context is provided via the Quick Chart option.

Quick Charts depict data from a trailing window of at least 30 days. Accompanying the chart are case details for each patient.

A “Patient Details” option is also available from the Pivots submenu on Report maps. Users specify their desired time frame, which can be expressed in hours, days, weeks, or months.

Bulletin: How EpiCenter Manages User Passwords

EpiCenter offers a set of built-in password complexity rules intended to enhance password security. EpiCenter customers may enable any subset of these rules to restrict user passwords.  When no password rules are enabled, EpiCenter will allow users to choose passwords without restriction. Passwords may be of any length and contain any combination of character types (upper/lower case letters, numbers, or punctuation).

Password Rules Supported by EpiCenter

As of the release of EpiCenter version 3.5.18, the password validation rules are as follows:

  • The password must be at least 8/9/10/12 characters (length to be selected by the customer).
  • The password must contain 1-digit character.
  • The password must contain at least 1 lowercase character.
  • The password must contain at least 1 non-alphanumeric character.
  • The password must contain at least 1 uppercase character.
  • The password must not contain any whitespace.
  • The password must not contain the person’s username, spelled either forward or backward.
  • Lock account for a certain length of time after a certain number of failed login attempts.
    • Length of time and number of failed login attempts must be specified by the customer.
  • The password will expire after a certain number of days.
    • The number of days must be specified by the customer.

If an organization enables one or more of the above password selection rules, EpiCenter will enforce all enabled rules for all new passwords. In other words, a chosen password must conform to every rule that has been activated. If any of the enabled rules is violated, the password is invalid and the system will disallow it.

Bulletin: Change in Definition of Chief Complaint Opioid-Related Evidence Classifier

Effective date: July 1, 2018

Health Monitoring’s evidence classifiers incorporate data from emergency department chief complaints, diagnosis codes, and clinical notes. Each classifier contains the classifications related to the data type. Each classification is defined by a particular set of keywords in conjunction with an absence of specified negative indicators.

Definition Change

At the request of the Connecticut Department of Health, two new brand names have been added to the Chief Complaint Opioid-Related Evidence Classifier.

The keywords “tramadol” and “hydromorph” are being added to that classifier’s Substance Opioid Brand classification. The relevance of these changes was deemed sufficiently universal and the impact on existing classifications sufficiently minor as to warrant applying them globally.

Impact on Existing Classifications

Since January 1, 2015, the start point for applying opioid-related classifications retroactively, there have been 2,852 chief complaints containing “tramadol” and 48 containing “hydromorph.” For “tramadol” that averages to roughly 2 per day systemwide, and thus less than 1 per day per state. Of those, 174 (169 “tramadol,” 5 “hydromorph”) contain sufficient additional information to warrant the classification “Suspected overdoses involving any opioid.” That works out to an average of 8 additional suspected opioid overdoses per year per state. The other two overdose categories will not be affected by this change.

Classification definitions (inclusion of keywords and exclusion of negative indicators) are developed based on the analysis of data received by the system. Words or phrases that do not appear in the data are not included in classifier definitions.