BACKGROUND: Implementing electronic lab reporting (ELR) has been a high priority for national and local public health agencies, and providers for several years. It has enjoyed a reasonable amount of success as more institutions transition to full electronic reporting and public health agencies are equipped to receive, consume and take action on these data. Though resources such as Meaningful Use legislation and federal technical and financial assistance exist for the implementation process, few resources exist on how to monitor and maintain quality ELR data once in implementation. Laboratories add, change and update test types and testing algorithms, laboratory systems, and other features that, along with staffing changes, inevitably affect the quality and stability of ELR feeds. It is important to create a reference resource for states and local jurisdictions on how to build fully or partially automated, engaged and responsive quality assurance programs to monitor and address significant changes as they develop in their ELR feeds.
METHODS: Structured interviews and literature reviews were used to establish a baseline of what other states or jurisdictions have instituted to monitor and/or control quality of ELR feeds. This information was used to develop an ELR quality assurance plan and design a generalized reference guide.
RESULTS: A post-implementation ELR quality assurance plan was developed for the North Carolina Division of Public Health (NCDPH). Feedback was provided to sending laboratories when issues were discovered and corrective actions or plans were instituted. From this work, a reference guide including universal data elements for review, scalable review process, and templates were developed for other jurisdictions to use as a development reference tool.
CONCLUSIONS: The quality assurance plan provided a framework for continual improvement in NCDPH’s ELR system. This ensured the quality of actionable data for epidemiologists and field staff tasked with using the data, resulting in decreased follow-up activities and more readily analyzable data. The reference guide can also serve other states and jurisdictions in their quest to maintain quality ELR feeds as there are commonalities across all ELR systems.