Turning ELR on, Turning Paper off: State Perspectives and Guidance Development Session

BACKGROUND:  Since 2010 CDC has provided focused support to advance electronic laboratory reporting (ELR) and there have been steady increases in the number of transmissions and volume.  In addition, in 2011 the Centers for Medicare & Medicaid Services Electronic Health Record Incentive Program's "meaningful use" initiative began offering enhanced reimbursements to eligible hospitals that implement ELR with public health agencies.  Stage 2 of meaningful use has begun and eligible hospitals are now required to send ongoing ELRs to public health agencies to receive enhanced reimbursements.  This requirement is motivating an increasing number of hospital laboratories to implement ELR.  Jurisdictions must have processes in place that enable them to engage with multiple laboratories simultaneously, move into production in a timely manner, and discontinue paper laboratory reporting.

METHODS:  While all jurisdictions are working with labs to initiate ELR, there’s substantial variability around how systematic and efficient those efforts are.  CDC will continue to work with jurisdictions to collect systematic information about laboratory results reporting.  The CSTE Electronic Laboratory and Disease Reporting Subcommittee (ELDRS) will work with jurisdictions to collect documented processes, help jurisdictions prepare for this panel session, and refine guidance.  CDC will also introduce this topic on its next national call (2/18/14). 

RESULTS:  This panel session will focus on discussion and development of best practices. CDC will present on the current status of ELR implementation.  Jurisdictions will report on processes they use to engage with laboratories, including transport setup and validating messages, performing acceptance testing, moving into production, turning paper off, and conducting ongoing quality assurance and auditing.  Attendees will come prepared to discuss their processes and comment on what is presented.  The ELDRS and CDC will facilitate the creation of a draft guidance document prior to the conference and update it using feedback from this session.  This session will contribute substantially to enabling jurisdictions to more efficiently implement ELR.

CONCLUSIONS:  Though jurisdictions are bringing on new ELR partners, the corresponding paper transmissions aren’t being turned off and many hospitals are now motivated to engage.  It is important to have a plan in place outlining efficient processes for onboarding laboratories, including systematic acceptance testing that expedites the production use of ELR in one or more surveillance information systems. Jurisdiction plans should include thresholds to use during acceptance testing, criteria for turning paper reports off when ELR moves into production, and a process for post-production testing/auditing of ELR feeds to ensure ongoing quality and compliance.