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How Illinois Used REDCap to Support Contact Monitoring for the 2015 Measles Outbreak

Posted By Jennifer Vahora and Stacey Hoferka, Thursday, June 11, 2015
Updated: Thursday, June 11, 2015

In January 2015, the Illinois Department of Public Health (IDPH) received a measles case report, the initial case identified in what soon became the second-largest US measles outbreak, with 15 confirmed cases and many exposed contacts in suburban Cook County in 2015. IDPH had recently acquired Research Electronic Data Capture (REDCap) from Vanderbilt University, a free and secure web application for building and managing online surveys and databases. REDCap is accessible through computers, tablets, and smartphones.

REDCap was being evaluated and tested for symptom monitoring in Ebola contacts, when the measles outbreak began. The robust and customizable functionality in REDCap allowed IDPH to rapidly mobilize the tool to support the local health department’s measles contact investigation. IDPH’s Applied Public Health Informatics Fellow, Jennifer Vahora, quickly modified the Ebola module she had built the month before in order to create a measles-specific questionnaire.

IDPH worked with the Medical Research Analytics and Informatics Alliance, a non-profit entity that supports the development and maintenance of the Public Health Node (PHN). The Public Health Node, as an agent of IDPH, connects directly to the Illinois Health Information Exchange and supports the technical receipt, aggregation and transformation of data sent to IDPH for the purpose of collecting Meaningful Use data from hospitals and providers, as well as the eXtensively Drug Resistant Organism (XDRO) registry.

Within 72 hours, the measles module was ready to be demonstrated and deployed by local health departments. The survey instrument was demonstrated to the Cook County and Chicago Departments of Public Health. Whitney Clegg and AJ Beron, two IDPH CDC/CSTE Applied Epidemiology Fellows, were trained to use REDCap and lead REDCap response activities at Cook County.

Within three days of the demonstration, Cook County deployed the REDCap survey instrument and offered REDCap to 33 (52%) of 63 low-risk contacts. After initial phone communication with contacts to explain the electronic monitoring option, REDCap was offered to contacts as an alternative to daily phone calls to report body temperature and the presence of symptoms. Seventeen contacts (52%) completed at least one survey. In a post-evaluation discussion, Cook County staff indicated that REDCap reduced staff time and effort necessary for monitoring low-risk contacts, made follow-up easier, and the layout enabled a quick review for detecting contacts who failed to report their symptoms daily. To enhance the tool for future use, Chicago and Cook County requested Spanish and Polish language translation, a vaccination history data collection tool, and the ability to manage multiple contacts within one household.

IDPH presented its experience with REDCap on a CSTE webinar on state innovations in active monitoring with the Georgia Department of Public Health. To date, IDPH has received inquiries from four state and local health departments and one international institute. IDPH is currently working to develop a protocol for the use of REDCap in outbreaks, modify the existing REDCap project to meet LHD needs, and expand use of REDCap for foodborne illness outbreaks, rabies animal testing, and sharing of lab testing information. While IDPH’s use of REDCap is evolving, it has the potential utility for additional public health surveillance activities and future collaborations with other public health jurisdictions.

Jennifer Vahora, MPH is an Applied Public Health Informatics fellow and Stacey Hoferka, MPH, MSIS is a surveillance and informatics epidemiologist at the Illinois Department of Public Health. For more information on Project SHINE fellowships, please visit or contact Workforce Director Amanda Masters. For more information on measles monitoring, please visit the CSTE website.

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