Condensed Messaging Guides for Electronic Laboratory Reporting and Syndromic Surveillance Programs in North Dakota

BACKGROUND: The Centers for Disease Control and Prevention (CDC) published guidelines outlining the contents and submission of HL7 messages for the purpose of fulfilling Meaningful Use (MU) objectives. States may also create their own guidelines specific to the submission and message requirements of that state. Typical messaging guides can be become lengthy, containing detailed information that is already known to IT professionals familiar with HL7 and MU. These professionals routinely contacted the North Dakota Department of Health (NDDoH) to ask specific questions: how to establish a connection with NDDoH and which message fields were required to be filled. Several resources were needed in order to provide documentation on North Dakota’s requirements. To address the needs of IT professionals already well-versed in the process, NDDoH created condensed messaging specification guides for their Electronic Laboratory Reporting (ELR) and Syndromic Surveillance (SS) programs. These guides address the most frequently asked questions posed by health IT professionals and laboratories in an effort to reduce the number of redundant questions as well as provide North Dakota specific information.

METHODS: NDDoH created condensed specification messaging guides for both ELR and SS, focusing on two areas: directions for establishing a connection to NDDoH and a table containing the required HL7 messaging fields for North Dakota. Also included in the required fields section is a brief “Quality Control” section addressing fields of special importance often missed or submitted incorrectly: diagnosis code and patient ID for SS; specimen source, observation result, and patient address for ELR. Each guide includes a hyperlink to their full length companion guides for users requiring more detailed information.

RESULTS: At seven pages, the NDDoH condensed specification guide for SS is 85% shorter than the full-length national guide. For ELR, the condensed specification is 5 pages, compared with 86 pages for the full-length version, a 96% reduction. As the guides address our most frequently asked questions, it is often the only documentation the NDDoH needs to provide. The guides can be found on the NDDoH MU webpage: http://www.ndhealth.gov/disease/ELR/.

CONCLUSIONS: The NDDoH ELR and SS condensed messaging guides provide a concise and singular resource for IT professionals looking to fulfill MU requirements for ELR and SS. Since implementation, NDDoH receives fewer inquiries regarding connection and required fields. The correct completion and submission of required fields, specifically those included in the quality control section, maximizes the utility of messages for the purpose of public health surveillance.