Public health departments collaborate with partners in their efforts to accelerate ELR. Important partners are the APHL, CDC, CMS, CSTE, laboratories, the ONC, and vendors.


For reporting to public health agencies, laboratories are moving from paper and fax reporting to electronic reporting. For eligible hospitals, this transition can contribute to successful attestation for ELR Meaningful Use.
Laboratories perform the following tasks:

  • Send laboratory reports for reportable conditions to public health agencies electronically as possible, with a goal to send all reports electronically.
  • Communicate regularly with state, territorial, city, and county public health departments and vendors about technical barriers to ELR adoption.
  • Work with public health departments and vendors to address technical and scheduling roadblocks.


CDC supports and monitors ELR implementations and progress at the national level, funds ELR via the Epidemiology and Laboratory Capacity for Infectious Diseases (ELC) cooperative agreement, provides technical assistance for ELR, and reports on the status of ELR in publications and presentations.

CDC performs the following tasks:

  • Through quarterly calls and annual and quarterly reporting, monitors the progress of ELR nationally.
  • Facilitates increased efficiency of ELR test-to-production timelines.
  • Provides funding to support ELR adoption.
  • Provides ELR guidance and recommendations to state, territorial, city, and county public health departments.
  • Provides Technical Assistance through a cooperative agreement with the Association of Public Health Laboratories (APHL).
  • Monitors and encourages public health departments’ use of technical assistance to address gaps in ELR.
  • Using quarterly calls, conference presentations, email distributions, data visualizations, and other reports, communicates detailed information about ELR progress and roadblocks to ELR partners.
  • Produces journal articles, press releases, progress and success stories, and other public communications related to ELR.
  • Coordinates ELR with specific CDC program areas.


Vendors are critical partners in ELR. Without enhancements and updates to existing commercial software, and implementation of new software, many labs cannot move forward with ELR.
Vendors perform the following tasks:

  • Schedule and complete software upgrades in a timely manner to support customers’ transmissions of HL7 2.5.1 laboratory reporting messages.
  • Mitigate prolonged timelines for upgrades whenever possible.
  • Provide roadmaps to customers of future enhancements related to ELR.
  • Enhance software and processes to support HL7 2.5.1 message formats for transmitting laboratory reports for notifiable conditions electronically.
  • Prioritize ELR-related development work to implement enhancements that will benefit that largest numbers of customers and have the biggest impact to Meaningful Use certifications first.

Association of Public Health Laboratories (APHL)

Through a CDC cooperative agreement, APHL administers Technical Assistance to state, territory, city, and county public health departments.
APHL performs the following tasks:

APHL website – Electronic Laboratory Reporting pdf icon[PDF – 2 pages]external icon (pdf), Data Exchange and Interoperability Resourcesexternal icon, Data Exchange Initiativesexternal icon.

Council of State and Territorial Epidemiologists (CSTE)

CSTE performs the following tasks:

CSTE website – Surveillance / Informatics: ELDRexternal icon.

Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC)

CMSexternal icon and the ONCexternal icon administer the ELR Meaningful Use (EHR Incentives) federal program. ELR is one of several public health core objectives in Stage 2 of Meaningful Use.

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