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BACKGROUND: Since Meaningful Use (MU) Stage 1, the Public Health community has had 4+ years of experience in implementing HL7 Version 2.5.1 Implementation Guide: Electronic Laboratory Reporting to Public Health, Release 1 (ELR-R1). Following a year of editing, ballot and review, Release 2 of this guide (ELR-R2) was published by HL7 in November of 2013 in order to be incorporated into MU Stage 3. The Goal of ELR-R2 was to bridge the gap between it and other laboratory related HL7 Version 2.5.1 Implementation Guide specified in Meaningful Use, correcting errors, strengthening requirements, and removing ambiguity. With this new release, however, comes the pain of migration. This presentation outlines the challenges and potential for the public health professional in migrating from ELR-R1 to ELR-R2.
METHODS: Emphasizing the fact that ELR-R2 is mostly unchanged from ELR-R1, the differences can be divided into those that require little or no attention in the migration and those where potential challenges exists. An example is support of an HL7 Message level Acknowledgement message. Best practices for Public Health Agency receiving systems can mitigate the pain of migrating to ELR-R2. Lessons learned from pilot implementations need to be shared with the Public Health community. Tools such as ELR-R2 messaging profiles, sample messages, vocabulary repositories, and support from the NIST certification site can also help public health with their implementations.
RESULTS: There are going to be technical hurdles migrating from ELR-R1 to ELR-R2. Planning and creating a migration plan for Public Health is an essential task as well. Finally, Public Health has the opportunity/ability to shape these specifications based on their needs with feedback on the standard and should take advantage of it.
CONCLUSIONS: The presentation is intended to prepare Public Health for MU stage 3 and ELR-R2 by guiding them through the various issues in migrating from ELR-1 to ELR-2. The ultimate benefit of ELR-R2 is to allow labs to use a single base messaging standard for both their providers and when reporting to Public Health. As standardized electronic lab order and results messaging expands due to Meaningful Use, there is the potential to increase adoption of ELR-R2 as a single ELR standard. Public Health needs to be proactive and prepared.