Lab Matters Fall 2023 | Page 65

APHL 2023 POSTER ABSTRACTS for communicable diseases and newborn screening . The solution combines an SQL database with Rhapsody ’ s enterprise architecture and web service capabilities to enable a unified pathway for multiple electronic data exchanges . Results : The OSPHL solution is now in production for PHLIP messaging , with plans to add LRN messaging . OSPHL will pilot the ETOR component of the solution in spring 2023 . This solution is configurable , so it can accommodate multiple HL7 formats and can quickly change to accommodate new tests or workflows or requirements for sharing data . The solution was designed to be LIMS-agnostic , receiving orders and sending results for two separate LIMS , and it will be adaptable should OSPHL implement a new LIMS in the future . The Rhapsody route is a configurable , scalable solution , allowing OSPHL to nimbly respond to new outbreaks , changing reporting mandates , and new testing needs . Furthermore , OSPHL can leverage the data stored in the SQL database , as well as the inherent functionality of the Rhapsody integration engine , to monitor and troubleshoot all messaging activity including providing a means for transactional reporting as paper test orders are replaced by electronic orders , potentially using a broker . Conclusion : OSPHL ’ s approach to data exchange realizes many of the goals of DMI and is in line with CDC ’ s commitment to strengthen data reporting , management , and analytics across public health .

Presenter : Laurel Boyd , laurel . boyd @ oha . oregon . gov

Centralizing Electronic Laboratory Reporting ( ELR ) Beyond COVID-19 : Challenges , Lessons , and Considerations for the Future

P . Zarcone 1 , V . Lee 2 , M . Malai 1 ; 1 Datapult , an APHL Company ,

2

Clinical Architecture

Background : During the pandemic , state-based public health agencies were able to demonstrate the capacity to accept electronic results in the HL7 v2.5.1 ELR standard . With the foundation of centralized ELR built on the AIMS platform for COVID-19 , there is an opportunity to use these data pathways to increase the use of electronic means to report laboratory data beyond SARS-CoV-2 test results . APHL , via Datapult , has developed a service that expands its ELR capabilities from one infectious agent to over ten ( 10 ), and has plans to expand to over 90 by the end of 2023 . Expanding beyond COVID-19 is not easy : for the service to achieve the goal of reducing burden on public health agencies and laboratories , it must tailor reporting to the rules and requirements of each jurisdiction . Datapult , working together with Clinical Architecture , developed the ELR process that will allow for rule-driven , tailored reporting . This poster describes the challenges and lessons learned when deploying this service , and considerations for further centralizing ELR for any reportable test result . Challenges and Solutions : When automating ELR in a centralized manner , the first problem to address is variable reporting requirements . These variations are presented in several ways : the types of test results , the types of infectious agents , and the number and types of supplemental results ( like A1C or CD4 ), among others . The poster describes each of the challenges that the team faced and how these were addressed to achieve a centralized ELR service . Method : The poster illustrates the process taken to create a modular framework that can be combined in various ways to mirror any jurisdiction ’ s ELR rules . To develop this modular rule set , the rules were decomposed into the different “” reportability flavors ” ( e . g ., positive , indeterminate , negative ) and “” reportability factors ” ( e . g ., antibody , antigen , nucleic acid , viral load ). These modules can then be combined in any permutation to adhere to each jurisdiction ’ s published rules . Initial Real-World Results and Lessons Learned : The initial release of this service is planned for March 2023 and the first few months of results will be shared via the poster . These real-world results will include challenges that presented themselves in real-world use and how they were addressed , and quantitative metrics such as the ELR volume stratified by test type . Considerations : Laboratories must be ready to report results for any scenario — whether this be reporting for endemic diseases or reporting for emerging infectious diseases . The poster will provide considerations as visualized questions / prompts that can be considered by individuals who attend the poster session .

Presenter : Victor Lee , victor _ lee @ clinicalarchitecture . com

Development of a COVID-19 Test Ordering System at the Colorado State Laboratory

C . Stark 1 , J . Nucci 1 , S . Shakya 2 ; 1 Colorado Department of Public Health and Environment State Laboratory , 2 Colorado Governor ’ s Office of Information Technology

On March 5 , 2020 , the first positive COVID-19 case was confirmed in Colorado . At this time , all clinical testing at the Colorado Department of Public Health and Environment ( CDPHE ) State Laboratory was ordered on paper submission forms . In response to the pandemic , the State Lab became responsible for providing surveillance testing for long-term care , community outreach and outbreak response . The volume of test orders rapidly increased beyond the lab ’ s capacity to perform manual data entry . Electronic test ordering was first implemented using the LabOnline web portal integrated with our Horizon LIMS but was limited to single sample orders . The need to provide testing services to large institutional populations , such as correctional and long-term care facilities , led the State Lab to develop a CSV file-based interface capable of ordering thousands of tests at a time . However , properly formatting CSV files proved to be difficult for clients without direct interface capabilities . To provide customers with a simple , robust means to upload high-volume test requests , the State Lab , in collaboration with OIT ( Governor ’ s Office of Information Technology ), developed the Colorado Test Ordering System ( CTOS ) web application . CTOS easily handled more than 55,000 sample submissions per week from more than 350 sites at the height of the pandemic . The lessons learned and technology developed will serve the State of Colorado during future crises , and the CTOS framework has already been deployed to assist with other data acquisition challenges .

Presenter : Justin Nucci , justin . nucci @ state . co . us

Electronic Case Reporting ( eCR ) Data Quality Assessment and Reporting

J . Park , L . Parlier , J Michael Consulting

The APHL Electronic Case Reporting ( eCR ) Direct Support team works under the auspices of the APHL eCR Program to assist PHAs with the implementation of eCR . eCR provides an efficient and reliable source of encounter based clinical data that is useful in the timely reporting of cases of notifiable conditions to public health departments . The APHL eCR direct support team created a framework and set of tools to assess and report the quality of Electronic Initial Case Report ( eICR ) messages received