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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 a workgroup organization chart

Click here for complete workgroup membership listing

Task Force Steering Committee
Bob Rolfs (CSTE)
Bob Pinner (CDC)

Project Manager:
Shu McGarvey (CDC - NG)

Lisa Ferland (CSTE)
Patina Zarcone (APHL)
John Abellera (CDC)
Laura Conn (CDC)

Kaley Smith (CDC-McKing)
Monica Huang (CSTE)
Tom Safranek (CSTE)
Laura Conn (CDC)
Ira Lubin (CDC)
Nikolay Lipskiy (CDC)
Perry Smith (CSTE)
Chris Braden (CDC)
JA Magnuson (CSTE)
Dan Jernigan (CDC)
Patrick Luedtke (APHL)
The workgroups and their charges are:
Meaningful Use Work Group Activities
To develop a strategic plan for coordination and communication among states, CDC and the Office of the National Coordinator for Heath Information Technology (ONC).

Perry Smith (CSTE)
Jim Kirkwood (CDC/ASTHO)

Staff SME:
Sanjeev Tandon (CDC)
  • 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.
  • Drafted a Communications Plan for ELR Stakeholders.
    Available August, 2011
  • Drafted a Meaningful Use (MU) Educational Packet.
    Available August, 2011
  • MU FAQs to be posted on CDC MU website on an on-going basis.
Resource Needs/ Capacity Assessment Work Group Activities
Articulating what resources are needed to implement local/state ELR through a capacity assessment.

Dan Pollock (CDC)
Laurie Smithee (CSTE)

Staff SME:
John Abellera (CDC)
Danny Martin (APHL)
  • Conducted a 1-1/2 day on-site meeting with key ELR stakeholders.
  • Drafted 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
      Available August, 2011
  • Questionnaire to periodically obtain updates on state ELR implementation status to be developed, if needed.
Standards Work Group Activities
Facilitate the reporting of electronic laboratory data to public health agencies throughout the U.S. by:
  1. Harmonizing existing ELR Messaging and Vocabulary Standards to reduce variations.
  2. Providing guidance with regard to the implementation of ELR Messaging and Vocabulary Standards.

Rita Altamore (CSTE)
Dari Shirazi (APHL)

Staff SME:
Sundak Ganesan (CDC-NG)
Cindy Vinion (CDC-NG)
  • 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.
    Available fall 2011
  • Developing Reportable Conditions Mapping Tables – (RCMT).
  • Stage 1 (of 3 Stages) conditions to be mapped by
    end of June.
  • Publish via PHIN VADS.
  • Providing a guidance document identifying the challenges, best practices, & solution recommendations for adopters of ELR messaging and vocabulary standards.
Legal Considerations Work Group Activities
  1. Identifying key legal issues surrounding the implementation of ELR in the states,
  2. Researching how selected states with illustrative or generalizable experiences have coped with such legal issues, and
  3. Based on information acquired and if appropriate, considering whether law-related products or tools useful to states regarding legal issues should be developed in the future.

David Blythe (CSTE)
Fred Shaw (CDC)

Staff SME:
Molly Berkery(CDC)
Caitlin Shockey (CDC)
Jean O'Connor (CDC)
  • 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.
    Available fall 2011
  • Plan for Developing Legal Tools for State and Local Jurisdictions beginning in August, 2011.
LIS Vendors/Large Lab Work Group Activities
  1. Develop standards-compliant and efficient approach for vendors interfacing with PH
  2. Build on work with large national labs to ensure full implementation of ELR
  3. Get LIS software solutions to include appropriate ELR standards in their products prior to certification

Tom Safranek (CSTE)
Dan Jernigan (CDC)

Staff SME:
Arun Srinivasan (CDC)
Jack Krueger – assist (APHL)
  • Deployed LIS Vendor survey and received responses from 75% of vendors.
  • Drafted whitepaper on best practices for vendors to implement ELR.
    Available August, 2011
  • Drafting whitepaper on best practices for large labs to implement ELR.
    Available Aug/Sept 2011
  • 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.