INFORMATICS
AIMS: 10 Years in the Making
by Rachel Shepherd, specialist, Informatics
At the August Public Health Informatics
Conference in Atlanta something rather
extraordinary happened. In the nearly
twenty sessions that APHL presented as
part of the conference’s first ever public
health laboratory (PHL) track, and during
the live demonstrations of data exchange
in action, not once did we have to
explain the APHL Informatics Messaging
Services (AIMS) platform. Hundreds of
attendees, ranging from public health,
health care and IT professionals were
well aware of how this platform has
advanced the electronic exchange of data
at a national level, and eager to learn
about its involvement in projects that are
continuing to transform public health.
From LIMS to AIMS
2018 marks the ten-year anniversary
of the development of AIMS, but its
origins date back to the early 2000s
when laboratories were first beginning
to acquire laboratory information
management systems (LIMS). With the
advent of LIMS, individual laboratories
were able to increase efficiency and
standardize internal operational
procedures, but there wasn’t a unifying
force to advance public health as an
entity. APHL convened members and
laboratory leaders to establish guidance
and set requirements standards for all
LIMS. Principal among them: that LIMS
should facilitate the sharing of data.
AIMS came onto the scene in 2008 as a
route-not-read hub to transmit flu data
to the US Centers for Disease Control and
Prevention (CDC) for surveillance; any
laboratory could connect and use it as a
message router. Through this initiative,
nearly all state public health labs in the
nation have established connections with
AIMS.
Over the last ten years, AIMS has
morphed from a connecting hub and
message router to a fully-functional
enterprise platform that offers a variety
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LAB MATTERS Fall 2018
national reporting system to get antibiotic
resistance susceptibility testing data
into the right hands, quickly. Through
this initiative, AIMS is supporting 57
laboratories testing six pathogens, and
multiple data flows including electronic
test orders and results (ETOR) as well as
reporting national surveillance data.
Over the last ten years, AIMS has
morphed from a connecting hub and
message router to a fully-functional
enterprise platform that offers a
variety of interoperability services
and resources.
of interoperability services and resources.
AIMS accepts multiple transport protocols
so that users don’t have to maintain
different types of connections for different
types of data or trading partners. AIMS
also has portal services that automatically
transform and translate data to different
message formats and standards, and
has been given authority to operate at
FISMA moderate, enabling AIMS to be
secure and entrusted with managing and
transporting patient level data.
Today, there are over 200 trading partners
on AIMS—PHLs and agencies, clinical
and commercial laboratories, hospitals
and others. AIMS hosts 112 servers and
transports more than 25 million messages
every month.
A Foundation for National Initiatives
AIMS serves as the backbone for major
national initiatives. For starters, there’s
CDC’s Antibiotic Resistance Lab Network
(ARLN) for which AIMS is hosting a
Then there’s electronic case reporting
and the Digital Bridge, an immense
collaboration between public health
entities, systems vendors, public health
agencies and healthcare providers.
Currently, notifiable conditions are
largely reported manually by the medical
provider to the health department. The
Digital Bridge is working to revolutionize
the way healthcare providers and public
health jurisdictions communicate by
converting this type of one-directional
report into an automated and
multifaceted bi-directional dialogue, all
traveling through AIMS.
The old adage “time is money” translates
in public health to “time is lives.” When
public health entities connect to AIMS,
they enable faster transmission of a
higher volume of data for surveillance
or trend analysis. With Digital Bridge,
responses are reported back to the
provider faster and with public health
guidance on how to proceed, making
intervention more immediate.
So what’s next for AIMS? If the PHI
Conference is any indication, the future is
ETOR. Web portals on AIMS are currently
being used by laboratories to automate the
process of receiving orders and sending
test results for emerging threats. Also
coming is more migration to the cloud.
As laboratories’ LIMS age and they need
to restart the process of LIMS acquisition
and implementation, more states are
looking to cloud-based LIMS solutions.
And yes, AIMS can host those too. n
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