Electronic Laboratory Reporting ELR

1
Electronic Laboratory Reporting (ELR)

• Mary Wedig
• Electronic Laboratory Reporting Coordinator
• Wisconsin State Laboratory of Hygiene
• March 2007
• E-mail wedig_at_mail.slh.wisc.edu
• Phone [phone]

2
Preview

• WEDSS
• Describe ELR
• ELR implementation
• Current Status

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WEDSS

• Wisconsin Electronic Disease Surveillance System
• System for public health
• Secure web-based system for
• Disease reporting
• Outbreak management
• Investigation management for individual cases

4
WEDSS HIPAA Concerns

• Health Insurance Portability and Accountability
  Act
• Allows public health to receive information for
  the purpose of preventing or controlling disease,
  injury or disability
• WSLH as the statutorily-designated public health
  laboratory for the State of Wisconsin is acting
  as an agent of the WDPH when collecting ELR data
  for transmission to WEDSS

5
Laboratory Reporting

• Laboratory reporting is a critical component of
  disease surveillance
• Reporting Methods
• Manual Laboratory Reporting (via paper) -current
• Manual Laboratory Reporting (via Web) - future
• Electronic Laboratory Reporting - future

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Manual Laboratory Reporting (Paper)

• Form 4151
• May be discontinued in the future for ELR
  participating laboratories that meet
  certification requirements
• Certification requirements have not yet been
  defined

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Manual Laboratory Reporting (Web)

• Enter laboratory results directly into WEDSS
• Secure (password, etc.)
• Manual Laboratory result entry capability needs
  improvement

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Manual Laboratory Reporting (Web) Current Concerns

• Laboratory test/result entered by LOINC
• LOINC includes agent, test type, specimen type,
  etc.
• Choose from all LOINCs, not just from what your
  laboratory performs
• Example

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Electronic Laboratory Reporting (ELR)

• A means to automatically (or electronically) and
  rapidly report laboratory results for
  diseases/conditions required by Wisconsin
  statutes
• Laboratory data is transferred securely through
  PHINMS (Public Health Information Network
  Messaging System)
• Translated into LOINC and SNOMED codes to make
  clinical terminology readable across computer
  systems

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ELR Diagram
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ELR Laboratory Requirements

• Identify tests that produce reportable results
  (either by laboratory or reference laboratory)
• Produce HL7 2.3.1 or flat file from LIS
• Acquire necessary hardware and software
• Allocate personnel time

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ELR Process Overview - 1

• WSLH will contact partner laboratories to
  implement ELR
• Limited to laboratories reporting highest volume
  of reportable diseases/conditions
• WSLH will provide an introductory packet
• WSLH partner laboratories discuss packet during
  conference call
• Laboratory completes registration form
• WSLH arranges a Kick-off meeting with Atlas
  (vendor), laboratory and WSLH
• Laboratory, vendor and WSLH establish a time line
  for project completion

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ELR Process Overview - 2

• Laboratory acquires installs hardware,
  software, licenses and certificates
• Laboratory creates a test/result spreadsheet
• Atlas (vendor) assigns LOINC and SNOMED codes
• Atlas (vendor) remotely installs ELR Gateway at
  the laboratory
• Laboratory provides a test message
• Laboratory and WSLH perform quality assurance
  activities

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Where Are We?
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Where Are We?

• A vendor (Atlas) has been selected and contracts
  have been signed
• WSLH is in the process of implementing ELR from
  our LIS to WEDSS
• WSLH is learning about ELR, HL7, LOINC, SNOMED,
  WEDSS, etc.
• WSLH is receiving data from Milwaukee Health
  Department Laboratory that will be transmitted
• WSLH is contacting other laboratories with high
  number of reportable diseases/conditions

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WSLH

• WSLH is committed to providing support and
  assistance to laboratories throughout the
  evaluation, implementation and maintenance
  processes for ELR