Case Identification

Timely disease notification is an essential first step in initiating infectious disease case management. When a person is diagnosed with certain infectious diseases, their healthcare professional is required to report it to MDPH.

Reports are then entered as "events" into MAVEN. Using MAVEN enables MDPH and local health officials to capture and transfer appropriate public health, laboratory, and clinical data efficiently and securely over the internet in real-time. The system interfaces with Electronic Laboratory Reporting (ELR) efforts, and automatically notifies state and local officials 24/7/365 of any event requiring their attention.

For many infectious diseases, the diagnosis and public health interventions may require collection of clinical, laboratory, demographic, and social data. The type of disease will determine the type and frequency of interventions that are needed.

Interventions must be culturally appropriate, and must provide continuity of care from the acute stage through to either completion of therapy (if indicated) or support during the chronic phase of illness.

Depending on the disease, the LBOH's role may be to investigate and manage the case. Although related, case investigation and case management should be considered two separate activities.

Infectious Disease Examples

One common infectious disease managed by LBOH nurses is tuberculosis (TB). LBOH nurses also play a role in perinatal Hepatitis B follow-up.

  • For both of these diseases, case managers continually assess the patient's needs, support systems, available and needed resources, and prescribed treatments
  • The volume of activities and the length of time that case management is required varies considerably because of the characteristics of the diseases

Throughout this training, these two diseases will be used as examples illustrating case management in action.

 

TB

Under regulation 105 CMR 365.200, people with suspected and/or confirmed TB are assigned a nurse case manager from the LBOH.

Perinatal Hepatitis B

Regulations allow for follow up of Hepatitis B-positive pregnant women and their infants:

  • Regulation 105 CMR 130.627 requires that all pregnant women be tested for Hepatitis B during each pregnancy
  • Regulation 105 CMR 300.000 requires that all Hepatitis B-positive labs be reported to MDPH, requires that providers report Hepatitis B diagnoses in pregnant women, and outlines how cases and contacts must be managed

Perinatal case management in Massachusetts uses MAVEN. Hepatitis B-positive labs are reported to MDPH through Electronic Laboratory Reporting (ELR).

Pregnancy status is then determined for Hepatitis B-positive women between the ages of 14-50.

  • Those women who are pregnant and Hepatitis B-positive are entered into case management
  • Case management includes interaction with both patients and providers