Assuring Data Quality of Electronically Submitted HIV Laboratory Data

BACKGROUND:  New York State Public Health Law requires laboratories conducting HIV-related testing for NYS providers and/or residents to electronically report any laboratory test, tests or series of tests approved for the diagnosis of HIV or for the periodic monitoring of HIV infection. Laboratories report using the Electronic Clinical Laboratory Reporting System (ECLRS) which serves as a single secure platform for all lab reporting in the State. The New York State Department of Health (NYSDOH) receives and processes 1.1 million HIV-related lab reports annually.

METHODS:   NYSDOH employs extensive, routine and rigorous data quality assurance methods to ensure accurate and timely laboratory surveillance data. Twice weekly assessment of submitted laboratory data is conducted using Statistical Analysis System (SAS) programs to identify critical errors, omission of data elements and to verify anticipated volume by report type for each submitter. Biannually, comprehensive count reconciliation and laboratory specific report cards are distributed. Biennially, an independent audit to assess gaps in reporting for each lab is conducted. Additional assessments are periodically performed using a CDC supplied program to monitor completeness and timeliness.

RESULTS: In 2013, 1.1 million results were received from 87 laboratories. 116 report cards were issued highlighting data completeness and timeliness. 19 labs had identified reporting gaps. Data completeness for critical data elements are as follows: first/last name: 100%, date of birth: 99.7%, sex/gender: 99.6%, race: 40.6%, ethnicity: 6.8%, address: 87.9%, provider name: 98.5% and provider address: 94.8%. Additionally, 2014 reporting gaps have been identified and are under investigation.

CONCLUSIONS:  Laboratory data are the foundation of HIV surveillance in NYS and are important proxies for identifying linkage and retention in HIV medical care. Therefore, ensuring efficient, appropriate and tested tools are used routinely to monitor and assure data quality is mainstay of the HIV surveillance program. NYSDOH’s early adoption of implementing electronic laboratory reporting necessitated the development and refinement of a variety of tools used to assess completeness of reporting and data quality assurance. These tools and methods have yielded marked improvements in completeness and timeliness of laboratory data submission and are an important contributor to quality of the surveillance system.