How To Implement ELR

A group of six people are attending a business meeting around a conference table. There is data on the screen behind them. Several are healthcare professionals wearing scrubs or stethoscopes.

Hospitals, including critical access hospitals, that want to implement ELR should pay attention to the required formats and can request technical assistance for a direct consultation.

ELR Formats

Reporting through ELR can be done in

  • 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

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.

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 targeted and general obstacles to successful electronic reporting between laboratories and testing organizations and public health departments.

To apply for ELR technical assistance, please complete the APHL smartsheet TA request form.

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

CDC and APHL 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