ShowMe WorldCare End User Manual

The user should always search to see if a record for an outbreak exists before creating a new one. If a record does not already exist, create a new one by clicking the New Outbreak/Investigation button at the bottom of the screen.

The default Outbreak/Investigation record is shown below.

Status Bar: The Outbreak/Investigation ID field will populate once the record is saved and the random system Outbreak Number is assigned. The Condition, Process Status and Resolution Status fields in the status bar will populate as the fields are completed.

# of Cases: This is a mandatory field and must be completed before the record can be saved. The user must manually update the number of cases involved in the outbreak/investigation.

Outbreak/Investigation Number: The outbreak/investigation number can be customized but the ShowMe WorldCare recommendation is to leave this field blank. This field will auto populate by a system-assigned number when saved.

• The system-assigned number will start with HF if Health Facility is chosen as the facility type.
• The system-assigned number will start with OB if Non-Health Facility is chosen as the facility type.
• Users may wish to customize this field to allow for easier outbreak identification.
• SMWC Tip: While ShowMe WorldCare allows any user with access to outbreak records to create an outbreak, best practice is to reach out to the assigned District Epidemiologist for their situational awareness of outbreaks. The District Epidemiologist can also provide guidance regarding whether the outbreak may already exist in ShowMe WorldCare to prevent duplicate outbreak records. Contact information for District Epidemiologists is available at https://health.mo.gov/living/healthcondiseases/communicable/communicabl… _district_map.pdf.

Condition: A condition must be selected in this field.

Facility Type: Health Facility or Non-Health Facility must be selected.

Location: If the outbreak/investigation is based around a location, that location can be selected by clicking on the drill-down icon to the right of this field to open the Location Dictionary. Within the Location Dictionary pop-up, various types of searches are possible to narrow the list of options. Click the location to make a selection, then click Save at the bottom of the pop-up.

• Some outbreaks may not be based around one specific location, in which case this field may be left blank. For example, a nationwide outbreak of a particular type of produce may impact multiple locations in Missouri.
• Unfortunately, there is not a way to customize this screen to allow a free text field for entry of locations that are not already in the Location Dictionary.
  • If additional custom tabs have been created for a condition, a free text field for entry of new locations can be found on the first tab.
  • If additional custom tabs have NOT been created for a condition, please contact the ShowMe WorldCare Help Desk to add the location that is needed. The Location does not have to be added to the record to save the record and proceed, so the user does not have to wait for the Help Desk to make the entry. Please note the record ID in the ShowMe WorldCare Help Desk ticket and the Help Desk can update this field once the location has been added to the dictionary.

Date of Onset: The user should enter the earliest date of onset among the records connected to the outbreak record.

Date Created: This field is automatically populated by the system and reflects the date the outbreak record was created.

Date Closed: This field should be left blank. It will automatically populate with the current date when the Closed by DHSS and Locked process status is selected.

Jurisdiction: This field will be used to note which jurisdiction is the lead for the investigation. This may be a local public health agency if the outbreak is contained within a single jurisdiction or based around a location such as a restaurant within that jurisdiction. For outbreak/investigations in which DHSS is the lead agency, the Outbreak only: State of Missouri or Outbreak only: Multistate jurisdiction should be selected.

• Outbreak only: State of Missouri should be used when an outbreak/investigation is contained within Missouri but crosses multiple Missouri jurisdictions.
• Outbreak only: Multistate should be used for outbreaks/investigations that involve multiple states.
• Questions about which jurisdiction to select should be directed toward the program that manages the condition or to the District Epidemiologist.

Security Info: Because outbreaks/investigations may often cross jurisdictional boundaries, the decision was made to apply more open access to Outbreak/Investigation records. These records have not been limited by jurisdiction. Any user with user group access to the Outbreak/Investigation records and condition security that includes the condition on the record will be able to see the record.

• However, a user will NOT be able to see that patients or contacts assigned to other jurisdictions are linked to the outbreak/investigation. If an outbreak has no patients or contacts assigned to the user’s jurisdiction, the Patients and Contacts tables will appear blank.
• There is an exception for records entered by a user. If the user entered a condition or contact record and then assigned it to another jurisdiction, that user will still be able to see and open that record because they entered it.

Investigator: A specific user can be designated as the lead investigator by selecting from the drop-down list of investigators.

• SMWC Tip: Because Outbreak/Investigation records are open to all jurisdictions, Investigators from all jurisdictions will be included in the Investigator list on these records. Users should be careful when selecting an investigator to ensure that they choose one from an appropriate jurisdiction.

Priority: Outbreak/investigation records can be ranked as High, Low or Medium priority. Please contact the program that manages the condition or the District Epidemiologist for questions about how to prioritize outbreaks/investigations.

Process Status: Please refer to the Process Status section of this manual for more details about process statuses and workflows.

Resolution Status: Please refer to the Resolution Status section of this manual for more details. Outbreak/Investigation records should only be assigned one of the Resolution Status options that begin with Outbreak only.

Outbreak/Investigation Type: This is an optional field that can be used to note the type of outbreak. If a program has created custom tabs for a condition, there is often a more specific field to capture this type of information on the other forms.

Notes/Remarks: Click the Add button to insert a new note or remark. In the Add a Note pop-up, type the information into the New Note field and click OK. This will insert the note prefaced by date/time/user information.

Patients/Contacts linked to this Outbreak/Investigation: If any patients or contacts have already been linked to the Outbreak/Investigation record, they will appear in the tables at the bottom of the record IF those records fall within the user’s jurisdiction security role.

To link an additional record to the outbreak/investigation, click the Link Existing Patient Condition/Record or Link Existing Contact Investigation drill-down just above the column headings and toward the right side of the screen. This will open a Select a Person pop-up. Use the search fields at the top of the pop-up to find the record that needs to be linked.

Click on the correct person’s ID number followed by the OK button to make a selection. The person will then be linked to the outbreak/investigation

If a condition is only using the single Outbreak/Investigation tab, click Submit at the bottom of the record to finish, run validation checks and submit the record.

Some conditions use additional tabs to collect more information. In that situation, extra tabs will appear when the Condition is selected. For example, most general communicable diseases are using three additional tabs named General, Vehicles and Laboratory. When additional tabs are used, the Submit button is NOT located at the bottom of the main Outbreak/Investigation tab. The user would need to Save at the bottom of the first tab and then click Next to move forward through the record.

The General tab for most general communicable disease conditions pulls some information from the first tab but contains many more fields to collect additional details. Please consult with the District Epidemiologist for questions about how to complete the additional Outbreak/Investigation tabs for general communicable diseases.

The Vehicles tab provides space to document details about outbreaks/investigations related to food or animals. The sections on this tab may be collapsed and/or disabled based upon the response to the Primary Mode of Transmission field on the General tab.

The Laboratory tab provides a place to enter/ingest laboratory test results that relate to the outbreak/investigation or the associated location.

• Results of tests on individuals should NOT be entered here; they should be entered on the appropriate condition record or contact investigation record.
• Examples of tests that should be entered on the Laboratory tab in the Outbreak/Investigation record include:
  • Soil samples
  • Water samples
  • Paint samples
  • Food items
  • Infant formula

When additional tabs are used, the Submit button will be located in the bottom right corner of the last tab. Click Submit to run all validation rules on the record and submit it.