Stream: Covid-19 Response
Topic: Electronic Lab Reporting (ELR) to Public Health
Andrea Pitkus, PhD, MLS(ASCP)CM, CSM (Mar 31 2020 at 13:08):
Is anyone working on Electronic Lab Reporting (ELR) to Public Health results? Asking as the VP has indicated CARES requires reporting of cases to HHS. ELR is required by law of all labs performing COVID-19 testing to respective jurisdictions (albein most is HL7 v 2.51). Seems like need to assist public health and hospitals in reporting directly to HHS.
(may only be able to lurk here occassionally due to my day job, but in case this helps jumpstart the need.)
Virginia Lorenzi (Mar 31 2020 at 17:23):
Because of Meaningful Use, all hospitals that got incentives/penalties due to that program and now PI are required to implement that spec. It goes to our local PH authority which in turns sends stuff to CDC. Same for Syndromic Surveillance
Craig Newman (Mar 31 2020 at 18:20):
I thought I saw that the new hospital report requirement was for hospitals to report straight to HHS via a flat file format (now ELR v2.5.1).
Craig Newman (Mar 31 2020 at 18:21):
https://www.whitehouse.gov/briefings-statements/text-letter-vice-president-hospital-administrators/
Virginia Lorenzi (Mar 31 2020 at 21:06):
Oh thats important. I missed that subtlety - duh
Andrea Pitkus, PhD, MLS(ASCP)CM, CSM (Apr 01 2020 at 01:31):
So ELR is required by law of all laboratories performing COVID-19 testing, whereas MU was only hospital based labs. Many laboratories such as reference labs, VA/DOD/Govt, blood banks, independent labs, physician office labs, were ineligible for MU incentives/didn't have to meet MU standards, EXCEPT ELR since it's required by law of all labs performing reportable testing.
Craig Newman (Apr 01 2020 at 12:25):
If the version of the reporting spread sheet I saw yesterday was the real deal (no reason to expect that it wasn't other than I didn't source it myself), the spread sheet wants counts (both for the day and cumulative) for things like number of tests run, number of positives, number of rejected specimens, etc and not actual result data (no PHI). So it couldn't be reported with ELR anyway (although anyone consolidating ELR test results could the counting and report).
Craig Newman (Apr 01 2020 at 12:26):
John Moehrke (Apr 01 2020 at 13:19):
I hadn't see the details they wanted reported... but was not comforted about it being reported using plain old email... so I hoped that it was summary metrics.
Andrea Pitkus, PhD, MLS(ASCP)CM, CSM (Apr 02 2020 at 01:24):
Yes, that's the version I saw too @Craig Newman The White House also doesn't want PHI. Several of my lab colleagues indicating they are creating reports to extract the data from the LIS and EHR to report their facilities' numbers.
John Moehrke (Apr 02 2020 at 12:50):
This is good "Privacy" news. It is clearly possible, but is surprising given how often privacy gets sacrificed during a crisis.
John Moehrke (Apr 02 2020 at 12:51):
for SANER, I want to watch this closely, as I have written the privacy/security considerations presuming the interface defined is summary metrics and not PHI or re-identifiable.
Andrea Pitkus, PhD, MLS(ASCP)CM, CSM (Apr 03 2020 at 12:09):
The other aspect which was discussed on CIMI and PHER calls yesterday is there are existing public health reporting/specifications for ELR and eCR. Using existing infrastructure, it might be easier to summarize that info required by law. (It also assumes everyone is reporting ELR and eCR correctly, which also isn't the case.) The other challenge is ELR is from the LIS and not sure how many have FHIR capabilities. For those with a shared database with the EHR, they may have those capabilities.
Riki Merrick (Apr 14 2020 at 01:25):
there are 2 reporting requirements - one for aggregate test data - the summary data - and that is flowing , not sure exactly how (not my project) and then there are direct sample level reports going to CDC (no patient info besides demographics that the PHLs feel are NOT PII, so differs by PHL what they include) - from Public Health Labs using ELR R1 2.5.1 for the most part (58 jurisdictions are live); the 6 large commercial labs send directly to CDC (I am not sure which version of HL7 is being used) and APHL is working on copying ELR that the labs are already sending to their PHAs to CDC - any ELR format that is supported as well as a csv flatfile for labs that don't have HL7 capabilities - that will hopefully also help the local/stae PHAs to get this info from them, as we are plannign to convert that sv file to HL7 v2.5.1 ELR R1
Andrea Pitkus, PhD, MLS(ASCP)CM, CSM (Apr 14 2020 at 02:47):
Awesome to hear @Riki Merrick Do you have any further info on barriers to ELR adoption for those labs still not reporting? If we had all labs reporting ELR (at a minimum COVID-19), then in theory, public health should have all the data to aggegrate/summarize for CDC/WH/FEMA, etc. Trying to get the paper/fax reports to electronic. Then hopefully all on Hl7 v 2.51. Of course, the last 10 years+ have gotten us to the current state ;)
Andrea Pitkus, PhD, MLS(ASCP)CM, CSM (May 13 2020 at 15:17):
Have folks seen the new CDC COVID-19 testing tracker? @ https://www.cdc.gov/covid-data-tracker/index.html
Heard these are coming from ELR reporting and summarized at a state/territorial level and nationally.
Curious how ELR numbers (which I'd consider most accurate as directly from labs) compare to FEMA hospital numbers and other sources of lab data?
@Abigail Watson @Gino Canessa fyi this should parallel the FEMA connectathon reporting of COVID-19 testing. Like their interface too.
Now only if we can get labs still reporting by paper, flat file, and fax to report ELR using HL7 v 2.51 so we can achieve interoperability on this aspect of lab reporting and single source of truth as critical decisions made on this information.
Last updated: Apr 12 2022 at 19:14 UTC
