Frequently Asked Questions (FAQs)

NBS is a CDC-developed integrated information system that helps local, state, and territorial public health departments manage reportable disease data and send notifiable disease data to CDC.

NBS provides a tool to support the public health investigation workflow and to process, analyze, and share disease-related health information. NBS also provides reporting jurisdictions with a NEDSS-compatible information system to transfer epidemiologic, laboratory, and clinical data efficiently and securely over the Internet.

Integrated surveillance information systems in reporting jurisdictions that are based on the National Electronic Disease Surveillance System (NEDSS) architectural standards are primary data sources for the National Notifiable Diseases Surveillance System (NNDSS). Jurisdictions use these information systems to create and send standards-based case notifications to CDC for NNDSS..

NBS provides a NEDSS-compatible data system for use by local, state, and territorial public health departments. It helps public health departments with

• integration of multiple diseases into one surveillance system to improve programmatic processes and reduce costs associated with supporting multiple systems;
• reportable disease surveillance by improving information sharing between healthcare providers and health departments and between health departments and CDC; and
• electronic laboratory reporting as part of the Meaningful Use initiative to improve public health disease reporting.

Currently, 22 health departments (19 states; Washington, DC; Guam; and U.S. Virgin Islands) use NBS to manage public health investigations and transfer general communicable disease surveillance data to CDC.

NBS supports surveillance for any type of condition. However, it is primarily used for state reportable and nationally notifiable conditions, most of which are infectious diseases. Public health reporting jurisdictions, the Council of State and Territorial Epidemiologists, and CDC work together to determine the list of conditions on an annual basis. Currently, more than 140 different diseases and conditions are tracked through NBS.

NBS offers the ability to add new conditions as needed, as well as to create data collection forms through a user interface without system development by using Page Builder functionality.

Data collected for surveillance purposes are used primarily at the local and state level to guide public health action. A subset of the data collected are sent to CDC to support surveillance at the national level. The data are used to

• identify cases of illness that affect public health,
• prevent additional cases of disease,
• ensure that appropriate interventions such as treatment are implemented,
• inform policy and funding decisions,
• evaluate interventions and programs, and
• monitor the incidence of disease over time.

NBS ensures the security of protected health information by meeting the requirements of the Health Insurance and Portability Protection Act (HIPPA) and additional state and federal requirements. Jurisdictions are encouraged to collect the minimum amount of information needed to perform public health functions, and access to the information is restricted. Information is stored and exchanged in accordance with current data security standards. NBS does not transmit patient identifying information (such as names, street addresses, telephone numbers, etc.) to CDC.

NBS is provided by CDC at no cost. However, the health department must have licenses for some software used by NBS.  CDC provides some of these components to the jurisdictions at no cost, but the jurisdiction must maintain licenses for the others.  The health department is responsible for the hardware and personnel needed to support the jurisdiction’s implementation of NBS.

NBS provides support for surveillance for more than 140 reportable conditions, electronic laboratory reporting (ELR), case reporting, and case notification to CDC, and CDC provides support to jurisdictions during implementation at no cost. However, the system does require configuration prior to use. For example, a state must set up the following:

• internal jurisdictions (counties, parishes, regions, etc.),
• disease program areas (general communicable, vaccine-preventable, etc.), and
• specific conditions on which the jurisdiction conducts surveillance.

The NBS Deployment Team works closely with the jurisdiction to accomplish the following NBS implementation activities:

• site readiness assessment,
• installation and configuration,
• transition to production, and
• production support.

Recommended Platform Configuration

Minimum Platform Configuration

• SAS 9.3 requires a 64-bit machine.
• Rhapsody may be hosted on one of the 32-bit machines.

Yes. Please see the list of licenses required and associated costs under the FAQ “What does it cost a health department to implement and maintain NBS?”

Data entry in NBS varies from jurisdiction to jurisdiction. In some jurisdictions information is entered centrally, such as at the state health department. A de-centralized model is used in other jurisdictions, and the data are entered by clerical and investigative staff in local health departments.  Some jurisdictions allow the healthcare provider to enter a case directly into the system.  The number of staff needed depends on the volume of disease reports that are not received electronically or entered by the provider.

NBS offers the ability to migrate data from a legacy system by using a system interface called Public Health Document Container (PHDC). PHDC is based on the HL7 data standard Clinical Document Architecture (CDA). Data from any legacy system can be mapped to the PHDC interface and transferred into NBS. Additional functionality is specifically designed for migration of sexually transmitted disease (STD) data from the CDC STD*MIS system.

Local system administration, including database maintenance, system configuration, and user management, is the responsibility of the jurisdiction. The memorandum of understanding (MOU) that is signed by the jurisdiction and CDC, as well as documentation available on the NBS web site, provides more detailed information on the roles and responsibilities of all system stakeholders.

The NBS Deployment Team uses a train-the-trainer approach. Training is provided as part of the initial implementation in a jurisdiction. Subsequent training for each new release also is provided in a train-the-trainer format through specific training sessions that accompany each release. It is the jurisdiction’s responsibility to provide their local users with training, including jurisdiction-specific workflows, policies, and procedures.

The CDC Epidemiology and Laboratory Capacity (ELC) Cooperative Agreement allows jurisdictions to request resources to help support an integrated surveillance system such as NBS and electronic laboratory results reporting. CDC funds the NBS Support Team, who provides assistance to NBS jurisdictions at no additional cost.