Lab Matters Fall 2018 | Page 22

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 20 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 PublicHealthLabs @APHL