BACKGROUND: The Vermont Department of Health (VDH) continues to work with all Vermont hospital laboratories to implement Electronic Laboratory Reporting (ELR) of notifiable conditions into the National Electronic Disease Surveillance System (NEDSS) using HL7 messaging. ELR offers long-term benefits to both laboratories and public health including increased timeliness and accuracy, elimination of duplicate data entry, and reduction of manual processes, such as handling paper-based reports. At VDH, the Health Information Exchange (HIE) and Infectious Disease Epidemiology (ID-Epi) programs were tasked with ELR implementation, which began in April 2013. Initial execution, however, posed challenges including vague roles for both HIE and ID-Epi, lack of structured and methodical processes, and unengaged laboratory partners. Beginning in the latter half of 2016, HIE and ID-Epi sought to create a unified vision, increase communication, define roles, and delineate a systematic and quantifiable process to identify measurable outcomes for onboarding new laboratories.
METHODS: Problem areas were identified by key members at VDH. A project charter was drafted in an effort to define roles specific to HIE and ID-Epi, and those duties shared by both groups. Bi-weekly meetings were scheduled for HIE and ID-Epi to come together regularly to discuss the project. Through collaboration with stakeholders, processes were outlined to quantify and organize the onboarding course and reconciliation procedure of each laboratory. Use of JIRA Software to track issues and tasks for project management began.
RESULTS: Since the project start date, VDH has successfully onboarded two hospital laboratories and three national laboratory facilities; 12 hospitals remain to be onboarded. Through both the project charter development and the scheduled bi-weekly meetings, the roles of both programs were recognized and were synthesized into a unified view for the goal of the project. With more structure to the HIE/ID-Epi relationship, the communication with hospital laboratories is more effective and creates a faster turnaround rate to pass through all the onboarding steps. The systematic processes created establish an effective method of moving forward with the remaining hospitals to go through the implementation process and overcome the challenges of validating and reconciling new electronic reports.
CONCLUSIONS: Improvements have been made to the HIE/ID-Epi relationship, which has improved the ELR project. The team continues to work closely together to improve the system to onboard Vermont’s remaining hospital laboratories, which is the ultimate goal of the project. The success of the ELR initiative will beneficially reshape the practice of public health infectious disease surveillance and investigation in Vermont.