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The California Department of Public Health (CDPH) was recently notified by Center for Disease Control (CDC) that a new Sars-CoV-2 Variant of Concern (VOC) was identified abroad and is projected to spread rapidly in the United States, including California, in the coming weeks. Preliminary data and surveillance from abroad indicates that the VOC is suspected to cause severe disease in children and elderly patients who are not up-to-date on COVID-19 vaccination. In the meantime, in California, many local health departments have downsized their workforces and will not have the staffing to stand up manual case investigation/contact tracing. CDPH leadership is asking the CalCONNECT and CalREDIE teams to be able to assist statewide surveillance efforts by helping identify the location and demographic data for cases infected with this particular VOC across California. CalCONNECT will also need to help local health departments prioritize outreach to cases infected with this VOC and also help prioritize resource allocation/treatment delivery to cases at highest risk of severe outcomes from this VOC.

The CalCONNECT solution is now required to be modified to meet this new demand of cases and update the integration with CalREDIE. How will the vendor plan the approach, provide resources, and execute the task to meet the demand? Please explain your: 1) ability to make this change off-cycle (i.e., in between scheduled release); 2) meetings with stakeholders to make sure changes are accurate, 3) plan to smoke test the system after release in production; and 4) plans to monitor to ensure those records show up when applicable.

California is currently experiencing a surge in COVID-19 cases due to a new, highly transmissible variant. The daily volume of new cases is overwhelming both the case data transfer from the surveillance database CalREDIE to CalCONNECT and the case data transfer from CalCONNECT back to CalREDIE. CDPH leadership is asking the CalCONNECT team to identify the points of the integration causing the data delays and provide short-term and long-term fixes at each point of delay. They would also like the CalCONNECT team to quantify the data delay (the time it takes for case data to transmit between the two systems and the size of the record backlog) and summarize the issue to end users, who may not possess technical knowledge.

Describe how you would: 1) identify the cause of the backlog; 2) identify any technical limitations of the solution; 3) recommend short- and long-term solutions; 4) quantify the data delay; and 5) message the cause to end users in a timely manner.

Due to an unexpected COVID-19 public health guidance change released by Center for Disease Control (CDC), the California Department of Public Health (CDPH) needs to quickly change statewide Isolation & Quarantine guidance, testing recommendations, and policies related to school/workplace COVID-19 mitigation and masking. The CalCONNECT Team learns of this change on Friday afternoon, and the change will go into effect in one week. The guidance changes impact which cases and contacts need to isolate or quarantine (based on new criteria), how many days they need to isolate or quarantine, and recommended frequency of testing.

This change has most significant impact to the Virtual Assistant (VA) products including the VA Case and Contact Surveys, VA Case and Contact Monitoring Tools, the VA FAQ Bot, and the VA SMS templates. This means that in one week thousands of people per day will receive out-of-date and incorrect health information from CDPH unless essential updates are implemented. Within these products there will likely need to be updates to: 1) copy and guidance 2) auto-calculated logic 3) survey flow/branching 4) criteria for automated send of the VA Survey 5) coordination with CalCONNECT updates and field mapping 6) other miscellaneous updates/changes.

Describe how you would plan the approach, gather requirements, execute the changes quickly, and coordinate with necessary stakeholders to ensure a timely and successful deployment of the enhancements.

The Reporting and Analytics team was tasked with the objective to run an advanced analysis to quantify and describe duplicate person records from the Account object in CalCONNECT in order to reduce confusion among records and increase precision. A report will be created to send to LHJs to notify them of potential duplicates. Due to many Local Health Jurisdictions downsizing, the idea of figuring out how to send this report back to CalCONNECT and bulk merge certain records to eliminate work burden is a possibility. The matching criteria should be consistent, but flexible. Data can differ across duplicate records and being able to ascertain differences is the upmost importance, as we do not want to override any meaningful data. Creating an indicator of similarities or a score of confidence across records has been considered using an array of ideas. Vigorous testing is required to make sure these reports are reliable and data is preserved. If given the ok, Reporting and Analytics would need to work with the Development team to figure out a way to implement the bulk merging. If bulk merging is questionable, reports would be sent out to LHJs quarterly. If successful, Reporting and Analytics would apply this tactic to other types of records, such as household.

Please describe to us your approach on solving data duplication issues that may arise and what functionality and features you would recommend in solving the issue.

CDPH has another project that is working with a large managed care organization to report COVID-19 cases to CDPH directly from their electronic health record (EHR) to streamline a state-required reporting process. As part of this transmission, the managed care organization will include information about whether a patient is at risk of severe disease due to COVID-19. CDPH leadership would like the CalCONNECT system to integrate with the process developed by the other project so that LHJ staff can identify new cases of COVID-19 among individuals at risk of severe disease and conduct outreach via the soft phone, Virtual Assistant (VA), and other tools in CalCONNECT in order to refer these cases to medical care.

Describe how you would:

1. Identify technical solutions and present them to CDPH SMEs for consideration.
2. Ensure that all new development meets the CDPH business requirements.
3. Coordinate the development of this integration across multiple teams within CDPH (and other contract staff).
4. Manage and update system documentation to include this new integration and feature.

Local Health Departments often have high staff turnover, so we expect a steady volume of requests to the CalCONNECT Help Desk. Often times local health department users will submit questions that go beyond the system functionality of CalCONNECT. The Help Desk team should be well versed in all CalCONNECT processes and functionality, and should also have a clear understanding of what questions are beyond the system and require consultation or handing off to a CDPH COVID-19 subject matter expert. The Help Desk will also be required to discern if an issue reported by a user is a newly identified bug, user-error, or a system limitation.

A new surge of COVID-19 has required health departments to redirect a large number of new users to CalCONNECT and, inevitably, the Help Desk has begun to receive a flurry of questions. A Help Desk team member receives three different requests from three different users: a password reset request, a request to register a new SPOT Liaison, and a question regarding if a positive COVID-19 home antigen test is considered presumptive laboratory evidence or supportive laboratory evidence for case investigation. Another Help Desk team member has received a report that cases created in the system two hours ago do not have laboratory results attached to them.

Describe how you would:

1. Train staff to triage/hand-off non-system questions to CDPH subject matter experts.
2. Ensure that help desk staff are providing the correct information regarding CalCONNECT.
3. Ensure that help desk staff are properly escalating/handing off issues to the correct team.
4. Monitor and track service desk tickets (including measuring wait times and quality of customer service); including integration with CDPH helpdesk system, and if applicable, any plan to migrate existing tickets.

Aside from pre-scheduled downtimes, CalCONNECT must be available 99.9% at 24 hours, 7 days per week. The State must have absolute assurance that there is no disruption to service and that data are immediately processed through and delivered to the downstream systems. On a daily basis, the State must have reports or system-level acknowledgement to upstream or other downstream systems of success or failure of the data processed through the system, and a method to validate that no data has been lost in transmission or processing.

1. Describe your approach to daily reconciliations.
2. Describe the solution performance monitoring systems and processes in the event of a data flow disruption.
3. Describe the solution approach to preventing and detecting whether services may be disrupted, based on benchmark levels.
4. Describe the solution approach to tracking data as it moves through the system.
5. Describe how State teams can access performance and tracking metrics.
6. Describe your approach in incident management response and service restoration, including communication management to CDPH and key stakeholders.

Your public health client has a high volume of professionals working internally, with partners outside the department and the public to support response to a major public health crisis.  The team relies on a system that ingests a high volume of data from multiple stakeholders  primarily using bulk and streaming API, REST and SOAP methods while also leveraging service bus, data lake and customer relationship management technologies. Additional essential components are virtual assistant and softphone technologies. This enables case management workers to respond statewide and allows data science professionals to rapidly analyze impact to communities. You have been tasked with taking on the maintenance and operation of this complex series of operations, data management and reporting/analytics, in the existing environment. 

Describe your approach for preparing for this role. Please include strategies for minimizing impact on current operations.

1. Describe all technical aspects of this transition you would consider in your planning.
2. Describe all customer support aspects of this transition you would consider in your planning.
3. Describe a transition plan approach you would consider knowing you would require coordination with multiple large counties and laboratories.
4. Describe your recommendation for maintaining the existing production operations while transitioning data to the new solution.
5. Describe your strategy for continuing to address change management during this period of transition.
6. Describe how the ownership and support of the solution can be transferred to another service provider at the conclusion of the contract.