The agreements should include

• A funding mechanism and guidance for core surveillance activities.

• Implementation of performance standards regarding revised and standardized case definitions, specifically through the use of

  • Revised case-reporting forms with required, standardized components.

  • Case evaluation and followup.

• Support for developing and implementing automated data-collection systems, including

  • Electronic laboratory reporting.

  • Electronic medical-record extraction systems.

  • Web-based, PHIN-compliant reporting systems.

CDC should provide more comprehensive guidance to states on surveillance for viral hepatitis. The committee suggests that CDC use the HIV surveillance system as a model. The committee focused on that surveillance model as an alternative to the current model because of its organization, availability of technical assistance, and provision of detailed guidelines. The strength of the model is in its centralized guidance, mandatory process and outcome standards, and oversight at a national level, all of which provide consistency in data among jurisdictions (Hall and Mokotoff, 2007).

CDC is able to oversee its national effort through separate cooperative agreements with each state and territory for specific core HIV surveillance activities (CDC, 2007). The agreements not only provide funding for enough dedicated staff to provide followup directly with providers and to conduct active surveillance but commit states and territories to specific methods and performance expectations. States are also provided with detailed guidance on case investigation, classification, and followup requirements (CDC/CSTE, 2006). To ensure consistency, CDC holds required disease-specific technical-assistance meetings for all grantees. Project officers and epidemiologists are assigned to each grantee. As of April 2008, all states and territories had implemented the confidential, name-based reporting method used for all other reportable infectious diseases (CDC, 2008d). The national HIV surveillance system will soon be able to achieve case counts with no duplicates among jurisdictions through an interstate reciprocal notification system wherein CDC provides quarterly reports on cases that might be duplicated between states on the basis of matching soundex codes,² dates