Sentinel 5.17.5 User Guide

Sentinel Background Processing

Sentinel saves a new case in the database by performing the following background processes in the order listed:

Gecoding - Process of identifying an address location.
Deduplication - Process of locating possible duplicate patients and/or cases.
Case Assignment and Jurisdiction - Assignment of a new case after the jurisdiction (Region/District, Program Area, etc.) has been determined according to configured assignment rules.

Geocoding Process

Geocoding is a process of identifying an address location. The resulting location is used within Sentinel for determining the jurisdiction and case maps.

Before geocoding can occur, the Investigation Address must be determined. The Investigation Address is determined by the availability, validity, and accuracy of the two requested addresses:

Patient Home Address – A valid patient home address is entered and the Event Date is between the From and To dates of a patient’s address history. Blank From and To dates are interpreted as prior to disease onset and the current date, respectively
Providing Physician Address – The patient home address is either invalid or unavailable and a valid physician address is provided. (Valid for Alaska and New Hampshire)
Blank – None of the two requested addresses are acceptable. For this event, the case is assigned to the State Supervisor for review. A subsequent referral to an LPHU (Field Epi Region/District or Local Health Department) occurs if an address can be obtained

Once the investigation address is determined, the street address is separated into components. For example, the following components can be identified from a street address:

House or street number
Street name
Street suffix (e.g., road, drive, avenue)
Street direction (e.g., east, west, north)
Secondary unit descriptors (e.g., apartment, room, building)

Using the official United States Postal Service abbreviations, elongated address component such as Street is replaced with the postal abbreviation of ST. The standard postal abbreviations are available at http://pe.usps.com/text/pub28/28apc_002.htm.

At a minimum, the geocoder requires the following address components to successfully return the address coordinates. If the address does not contain these components, Sentinel does not call the geocoder.

House or street number
Street name
City or ZIP code

The geocoder does not support the following:

PO boxes, RR and RFD addresses. If the address contains this type of information, Sentinel attempts to determine the jurisdiction based on the city, county, and zip code information, but case location cannot be mapped
Out-of-state addresses. If the address is an out-of-state address, the case is referred to the State for investigation and/or referral to the appropriate authorities

Geocode Source - It is a read-only field in the Investigation Address section of the Addresses tab page and it indicates the geocoding source for the investigation address location.

Deduplication Process

See the Deduplication Reports section for more information.

Case Assignment and Jurisdiction

The state administrators handle case assignment statewide uniquely per disease; otherwise, Sentinel determines the correct jurisdiction for a case and then assigns the case to the Local Health Jurisdiction administrator who is designated to receive the automated case assignment. This case assignment logic is based on the disease and the roles assigned to the user.

Case Assignment occurs using the following logic:

Disease Management - An investigator is automatically assigned cases if they are selected as the investigator in the Investigator (Auto Assign Case) drop-down for a specific disease(s)
If an investigator has not been selected for the disease of the case, the system evaluates the user list and assigns the case to the users with the appropriate roles and permissions. A State Administrator can create the appropriate role for a user by accessing Role Management and selecting options under Investigation Permissions and Data Access Level.
This is where a State Administrator can define which jurisdiction a user has access to
The system finds which users have access to the jurisdiction of a case and assign the case to these users

The jurisdiction is determined by the county of the investigation address.

If coordinates are not available, county can be determined based on city or zip code. Each jurisdiction is designated to one of several identified regions or districts within the state. Once the jurisdiction is determined, that value is used to retrieve the corresponding region or district.

Once the correct jurisdiction is established for a case, the case is assigned to the administrator of that jurisdiction who is designated to receive the automated case assignment. The administrator can then assign that case to any investigator within their jurisdiction.

Case assignments are handled separately for special disease program areas that are created by a State Administrators (see section on Program Management). The State Administrator can create a role with specific program access in the Program Access section when defining a role. The cases that fall into a defined program are assigned to users with roles that have access to that program.