Electronic Laboratory Reporting (ELR)

For Public Health

Key points

  • Electronic Laboratory Reporting sends laboratory reports quickly and securely to public health agencies.
  • Faster reporting helps health departments detect and respond to outbreaks sooner.
  • Standard formats make it easier for different healthcare, laboratory, and public health systems to share and use data.
Doctor using tablet with icon medical network on hospital background.

What is ELR?

Electronic Laboratory Reporting (ELR) for public health is the transmission of digital laboratory reports. Reporting often comes from laboratories and other testing entities to state and local public health departments.

ELR automates the reporting process by translating laboratory information into an electronic message that can be automatically sent and processed. This reduces manual data entry errors and ensures standardized, complete, and accurate laboratory reporting.

Did you know?

Investments in ELR since 2005 enabled health departments to rapidly scale-up in 2020. Existing infrastructure was leveraged to send real-time data to CDC for national situational awareness.

Why ELR is important

Outbreak preparedness

Population background with disease cluster web demonstrating the importance of ELR in outbreak response.
ELR enables faster detection and response during outbreaks.

ELR provides a critical tool for rapid detection and response to outbreaks. High-quality ELR data enables faster identification of clusters and improved management of public health emergencies.

Improved report quality

  • Faster electronic transmission
  • Reduced manual entry errors
  • More complete and consistent reports across sources
  • Better interoperability and data integration

Data interoperability

Timely Data for Rapid Response

Over 90%
of laboratory results sent to health departments nationally are sent as ELR in standardized formats. This increases data timeliness and accuracy for rapid case identification and outbreak response.

ELR strengthens the seamless exchange of information across laboratories, healthcare systems, public health agencies (state, territorial, and local), and CDC.

Data that is understandable, interpretable, and usable:

  • Improves patient care
  • Enhances surveillance
  • Increases administrative efficiency

How ELR works

ELR is part of the larger electronic laboratory data exchange landscape. Electronic test orders and results (ETOR) send test orders to laboratories and results back to submitters. ELR sends results to public health to accelerate surveillance and response.

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Infographic showing the data exchange ecosystem of electronic test orders, results, and laboratory reporting.
ELR and ETOR data flows in the electronic laboratory data exchange landscape.

This image shows the streamlined flow of electronic laboratory data. Two major components include electronic test orders and results (ETOR) and electronic laboratory reporting (ELR). With ETOR, a healthcare provider (submitter) sends test orders to a laboratory, which processes the tests and returns results. Those results are also transmitted via ELR from the testing entity to public health departments to support monitoring and response.

How ELR works

  • Laboratory testing and LIMS
    When a laboratory confirms a reportable condition (e.g., measles, HIV, rabies), patient and test data are securely entered into a Laboratory Information Management System (LIMS). Data may be entered manually by laboratory personnel or automatically by connected instruments.
  • Message creation
    LIMS generates standardized electronic messages. Messages are formatted to be understandable, interpretable, and usable across different healthcare, laboratory, and public health systems.
  • Transmission and processing
    Messages are sent electronically to state or local health departments. Receiving agencies process ELR data into surveillance systems, linking to case reports and helping accurately track diseases.
  • Public health action
    ELR allows health departments to connect related cases and identify outbreaks. Health agencies can quickly act to find other cases, stop further spread, share prevention messages, alert clinicians, and advise communities on how to better protect their health.

Implementing ELR for health departments

CDC's Role

  • Funding: Supports health departments through the Epidemiology and Laboratory Capacity (ELC) cooperative agreement.
  • Technical Assistance: Helps jurisdictions address technical barriers, improve reporting systems, and achieve interoperability goals.
  • Monitoring and Support: CDC tracks ELR progress nationally, ensuring consistency and continued improvement.

Technical assistance for ELR projects

CDC and the Association of Public Health Laboratories (APHL) provide technical assistance. APHL is a partner organization that strengthens laboratory systems for public health.

This support helps jurisdictions pursue ELR-related goals. Requests can include:

  • Assessing existing ELR processing
  • Adding ELR for new disease categories or laboratories
  • Performing vocabulary mapping and infrastructure development
  • Fine-tuning existing routes to eliminate errors
  • Updating ELR to align with new systems, software, or regulations
  • Troubleshooting persistent technical issues
  • Reducing manual steps in automated systems
  • Promoting inter-state and inter-jurisdictional data exchange

Additional questions may be sent to EDX@cdc.gov.

Keep Reading ELC in Action: Modernizing Health Information Systems
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