The ELR Task Force was a collaborative effort between the CDC, CSTE and APHL to promote the implementation of ELR. The vision was:
Vision: All labs (public and private) conducting clinical testing identify laboratory results that indicate a potential reportable condition for one of the jurisdictions they serve, format the information in a standard manner, and transmit appropriate messages to the responsible jurisdiction; all jurisdictions can and do receive and utilize the data.
The task force was formed in the spring of 2010 and its steering committee identified five high-level priorities:
- Develop a strategic plan for coordination between states, CDC and ONC.
- Develop, evaluate and endorse standards to reduce variation in what is required for ELR across the nation.
- Collaborate with APHL to compare and assure that PHLIP messages (formats, vocabulary, and transmission) and NEDSS messages are consistent and compatible to leverage the laboratory message infrastructure to communicate with clinicians, CDC, or state/local surveillance systems.
- Document legal considerations for electronic laboratory reporting and make available for other states to consider.
- Articulate the resources needed to implement state/local ELR through a needs/capacity assessment.
To tackle the priorities, five workgroups were formed. Each workgroup had a CSTE co-chair and a co-chair from APHL or CDC, and was staffed by a CDC subject matter expert. Workgroup members represented CDC, CSTE and APHL, and additional inputs were provided by the standards development organizations (SDOs), vendors and implementers. The workgroups were established in October 2010 and the majority of tasks were successfully completed between July –October 2011.
Click here for complete listing of workgroup membership and activities
Workgroup deliverables are available on the CSTE Surveillance and Informatics Electronic Laboratory and Disease Reporting Subcommittee page (http://www.cste.org/members/group.aspx?id=87606)
- Appointed Jim Kirkwood and Jim Daniels as liaisons to CDC-ONC
- Identified ELR POCs for each State.
- Documented a set of MU Terminology.
- Compiled a document listing funding sources, which shows opportunities for funding ELR.
- Communications Plan for ELR Stakeholders.
- ELR Meaningful Use (MU) Educational Packet.
- MU FAQs to be posted on CDC MU website on an on-going basis.
- Conducted a 1-1/2 day on-site meeting with key ELR stakeholders.
- Developed a Roadmap to ELR that consists of two checklists to provide guidance on steps required and resources needed to implement ELR:
- Process checklist
- Resource checklist
- Questionnaire to periodically obtain updates on state ELR implementation status to be developed, if needed.
- Compiled an environmental scan of electronic laboratory data exchange projects. On-going updates will be made available as new/additional projects are identified.
- In conjunction with the HL7 PHER Workgroup, identified and documented errata and clarifications for the HL7 v2.5.1 ELR IG. This will be submitted HL7 PHER in June 2011. If needed, ELR IG r2 proposal will be submitted to HL7 PHER in July, 2011.
- Updated PHIN VADS with missing value sets and/or values in value sets needed to support the ELR implementation guide.
- Harmonized / Reconciled specimen vocabulary (Specimen Type, Specimen Site, Specimen Site Modifier) to reduce variation in the transmission of specimen information currently in review.
- Gathering requirements for establishing a public health knowledgebase. As a precursor, harmonize associated efforts across the CDC, CSTE and states. Developing Reportable Conditions Mapping Tables (RCMT).
- Publish RCTC via PHIN VADS.
- Providing a guidance document identifying the challenges, best practices, & solution recommendations for adopters of ELR messaging and vocabulary standards.
- CSTE has launched a national assessment of ELR-related legal issues in all 50 states.
- Once available, results of the assessment will be analyzed.
- Initiated interviews with states as a part of in-depth research on ELR law in selected U.S. state and territorial jurisdictions.
- Consider developing legal tools for State and Local Jurisdictions
- Deployed LIS Vendor survey and received responses from 75% of vendors.
- Developed whitepaper on best practices for vendors to implement ELR.
- Developed whitepaper on best practices for large labs to implement ELR.
- Established a community directory for large labs and vendors.
- Documenting the process and outcomes of ELR implementation at a site by specific LIMS vendors who participated in the survey.