FEATURE
not a lot of people to maintain those data-
exchange routes or to add anything new
onto the system,” Johnson said. “That’s
been a very large challenge for us, and it’s
not getting better.”
One example of the laboratory’s data
challenges is newborn screening (NBS),
involving 91,000 specimens/year. Johnson
said, “Our larger-volume NBS hospitals
keep asking to do electronic data
exchange with us, because of the volume.
We’ve offered web portal access so they
can see the NBS results online, but the
results still have to be manually reentered
into patient records.” In this case, she
noted, “Some of those conditions we’re
screening for could be fatal for newborns.
Days matter.”
The informatics team at the Missouri State PHL (l to r:) Sandy
Jones, Shondra Johnson, and Debbie Burnette.
Photo: MO PHL
Our larger-volume newborn
screening hospitals keep asking to
do electronic data exchange with
us, because of the volume. We’ve
offered web portal access so they
can see the NBS results online,
but the results still have to be
manually reentered into patient
records. Some of those conditions
we’re screening for could be fatal
for newborns. Days matter.”
Shondra Johnson, PMP
12
LAB MATTERS Fall 2019
Seeking “the perfect world”
Of course, the full public health benefit
of a modern health IT infrastructure
cannot be realized or sustained without
a comparable investment in a public
health data science workforce. Keith
Higginbotham, IT systems manager
at the Alabama Department of Public
Health, said, “One of the things most
states struggle with is data exchange
messaging expertise.” At the moment, he
is trying to recruit two business analysts
for a syndromic surveillance project and
a lower-level IT professional to support
the public health laboratory, but has had
difficulty finding people with the right
skill sets.
Shondra Johnson, PMP, the Missouri State
Public Health Laboratory’s facilities and
support manager, is part of a three-person
informatics team overseeing day-to-day
informatics operations. In addition, the
Missouri Department of Health and Senior
Service—the laboratory’s parent agency—
has three integration engine developers
who serve the entire department. “When
you’re talking millions of messages, that’s
Higginbotham would love to implement
electronic NBS data exchange in his state
as well. He said, “Right now, if I want to
get an electronic NBS order, I have to go
to every single one of Alabama’s 50 or so
birthing facilities, talk to their IT staff,
find out if they’re capable of generating an
electronic order for a NBS test, make sure
the order that their system can generate
makes sense to my lab system and then
make sure the results message that my
LIMS would generate can be understood
and consumed by their EHR system.”
Both Higginbotham and Johnson share the
same dream: access to AIMS technology
and AIMS data integration specialists to
establish and maintain bidirectional data
transmission routes with major public
health partners.
“If I could just give AIMS our [test]
order and results formats and test
catalogue and then have them work
with all the various EHR vendors and
get our messages to work with their
systems, that’s the perfect world,” said
Higginbotham. “If APHL and AIMS could
build interfaces for even the top five EHR
systems, I wonder how many hospitals I
could quickly onboard.”
Shirazi said APHL has the technical, policy
and program management experience to
make that dream come true. In fact he
said, “This would be an awesome thing to
do, if we had the funding to do it.”
To give an idea of the potential staff time
PublicHealthLabs
@APHL
APHL.org