Implementing ELR

ELR and Data Interoperability

CDC supports and monitors ELR implementations at the national level, such as through provision of funding to health departments to support ELR through programs such as the Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC) cooperative agreement.

CDC also provides technical assistance, reports on the status of ELR, and works together with partners to ensure the continued success of public health ELR. Public health agencies and laboratories that report using ELR strengthen rapid reporting of state reportable diseases and enhance surveillance and preparedness capacity.

ELR contributes to data interoperability between hospitals, healthcare systems, public health departments, and CDC. Promoting data interoperability is intended to improve clinical patient care and increase administrative efficiency.

ELR Formats

Reporting through ELR can be done in a variety of ways. Examples include:

  • Laboratory reporting via HL7 v2.3.1- or v2.5.1-compliant messages
  • Web-based entry from the laboratory into a public health system (Reports entered manually by public health departments are not considered to be ELR.)
  • Proprietary extract/transform/load (ETL) processes that automatically move data from a laboratory system to a public health system

When ELR takes place via a compliant HL7 v2.5.1 message, it enables eligible hospitals to fulfill objectives towards data interoperability.

Achieving Data Interoperability‎

The success of these CDC investments is evident: over 90% of ELR sent nationally are now sent in standardized HL7-compliant messages. At the end of 2019, more than 4,400 hospital laboratories across the nation were sending HL7-compliant messages.

Technical Assistance for ELR Projects

Team meeting between various staff members including physicians, patient care team, and hospital administration showing graphs with data on a screen in background.
Technical assistance helps overcome obstacles to successful electronic reporting.

CDC and APHL provide technical assistance on ELR Projects. Technical assistance for ELR projects is available to all public health departments actively pursuing funded ELR objectives. ELR technical assistance engagements advance ELR and informatics implementations across jurisdictions. Technical assistance can help overcome general and targeted obstacles to successful electronic reporting between laboratories and testing organizations and public health departments.

ELR technical assistance teams evaluate each request after it is submitted to ensure the requested project is a good match for the ELR technical assistance resources available. CDC ELR staff will send a response within two weeks, and, if accepted, a resource is assigned to work on the project and a kickoff meeting is scheduled.

Typical project requests often include:

  • Performing technical assessment of existing ELR processing
  • Adding ELR for a disease category
  • Adding ELR for a public health, large commercial, or hospital lab
  • Performing vocabulary mapping and other cross-cutting analysis to develop an infrastructure for ELR in a jurisdiction
  • Fine-tuning existing routes or mappings to eliminate errors
  • Making changes to existing ELR in response to new surveillance, hospital, or laboratory systems; new software versions; or new state or federal regulations
  • Troubleshooting and resolving persistent challenging technical problems
  • Eliminating remaining manual intervention steps in mostly automated data transmission and processing programs
  • Facilitating partnerships to promote data exchange between states and territories

To apply for ELR technical assistance, please submit a data modernization technical assistance request in ELC Cooperative Agreement Management Platform (CAMP) or the Public Health Infrastructure Virtual Engagement (PHIVE) platform.

Questions can be sent to Jurisdictions may apply for as many ELR technical assistance projects as needed.