• 1987 - STD and HIV Programs adopt unified effort to maximize PS capacity.
• 1987 – PS offered to CHD HIV+ clients by STD
Program DIS.
• 1997 – HIV Reporting (July 1997)
• 1998 - PS for HIV+ clients increased 46%.
• 2002 – Policy Change- PS Offered to all HIV +
Persons Tested Through C/T Sites.
• 2008 – Automated HIV/STD record search capability via PRISM and HARS.
2

Data Encryption
Physical Security Access Controls
State Policy and Guidelines
*************************************************************************************************
Florida’s confidentiality and security exists to protect the individual and their medical information, regardless of the disease, as part of common practice in modern public health programs.
3

Physical Security
•
Hardware (server) locked within Data Center Building.
• Limited Access to building with monitored entrance 24/7.
• Background checks and security clearance policy.
• Agency/Program confidentiality and information security policies
Virtual Security
•
Firewalls –
• Active Antivirus,
• Security web scanning
• Behavior level monitoring
• Software to ensure latest security updates
• Network security that includes:
• User accounts with applied security access
• Software level user identification and security controls 4

Modern Web Applications/BSTD and Area STD
Programs: share security levels with internal network devices, in addition to encrypted VPN tunnels and no data stored on the device (simply a view into software and data on the server).
Device registered on Network
VPN
– Encrypted Connection
Device registered on Network
Mobile Connection:
• Device registration
• User Authentication
• Software Authentication
• Window to Data – Nothing
5 resident on Device Memory

Past: Silo systems and databases divided by disease
Future: Health
Information and
Electronic Health
Records
Healthy Evolution sustainability
– long term Holistic
Client
Centered
PCSI:
Program Collaboration and
Service Integration
Systems and Information Technology
Maturity Model:
Integrated Systems and Data Sharing
6

• 10+ Years of steady decline in federal, state and local resources
• Combined resources to maximize prevention impact
• Significant overlap in populations served
• Significant and increasing STD/HIV co-infection
• Standardization of information security policies and procedures across disease control programs
• Vastly Improved performance outcomes through information exchange between STD and HIV Programs
7

Reported STD Cases by sex, among clients who had a
+ HIV test on, or prior to the date of their STD diagnosis.
Florida, 2005-2011
3,500
3,000
2,500
2,000
1,500
1,000
500
0
Female
Male
Total
8
2005 2006 2007 2008 2009 2010 2011

Infectious Syphilis and HIV Co-infection
Florida, 2000 to 2011
1,400
1,200
1,000
800
600
400
9.8%
40
12.9%
64
18.9%
118
505
200
369
434
490
25%
164
29%
207
26.9%
29.2%
197
209
35%
32.4% 34.2%
26.3%
242
338
357
519
509
533
506
675
703
684
666
41.8%
523
727
0
2000 2001 2002 2003
Syphilis Alone
2004 2005 2006 2007 2008 2009 2010
Syphilis/HIV Co-infection
2011
9

Inter-program and Technology Advances to
Improve Service Delivery and Performance
Outcomes
• Standardization of Information Security Policies to allow for automated information exchange across Disease
Control Programs. (All DOH staff accountable!!)
• Reciprocal data exchange between STD/AIDS
Surveillance = Reduction in NIRs and improved intelligence for HIV Partner Services
• Electronic lab reporting to reduce STD Prevention and
PS timeframes
• Ability to conduct virtual QA/QI via PRISM
10

Inter-program and Technology Advances to
Improve Service Delivery and Performance
Outcomes
• AIDS Surveillance monitors clients with subsequent STD infections via PRISM
– Included in Annual Epi-profiles
– Used as key variable to evaluate “Prevention for
Positives ” initiatives and to guide resource allocation
• Testing and Treatment History for Incidence Surveillance
– DIS collect previous testing and antiretroviral use during PS sessions. Information used by AIDS
Surveillance when calculating incidence estimates
11

ELR
50
47
40
30
20
10
17
0
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Number Days Specimen Collect to Assigned for Partner Services
12

743
1355
1833
CHD Non-CHD
3029
CHD Non-CHD
13

32%
Reported Adult HIV (not AIDS) Cases, Florida
Through 2005
N=35,584
25%
Men Sex W/Men (MSM)
Through 2010
N=44,957
16%
Injecting Drug Use (IDU)
32%
MSM/IDU
0%
2%
8%
Data as of 12/31/2005
33%
Other
Heterosexual
Risk Not Reported or
Identified
2%
2%
7%
Note: NIRs NOT redistributed.
Data as of 06/30/2011
14
41%

:
– Maximize resources/increase efficiency
– Standardize and improve on information security policy and procedures (Fosters mutual confidence across programs that information will remain secure.
– Reach the greatest proportion of infected and exposed persons through PS, referral, link to services
– Provide holistic prevention services to clients
15