Lab Matters Winter 2023 | Page 29


Informatics Infrastructure Supports Antimicrobial Resistance Testing

By Alyssa Mattson , specialist , Informatics
Laboratory testing data is the cornerstone of public health decision making — driving patient treatment , epidemiologic investigations , outbreak response , resource allocations and policy development . Reliable and actionable testing data must move efficiently and multi-directionally — with minimal manual touchpoints — to rapidly inform patient care and public health solutions .
In the global effort to combat antimicrobial resistance ( AR ), early case detection and rapid intervention facilitate the containment of drugresistant pathogens , making electronic data exchange a foundational component of public health response . With the inception of the AR Laboratory Network in 2016 , the US Centers for Disease Control and Prevention ( CDC ) formalized a coordinated domestic testing and reporting strategy for 56 state and local jurisdictions , including enhanced capabilities within seven AR regional laboratories . AR Laboratory Network efforts are supported by the Epidemiology and Laboratory Capacity ( ELC ) cooperative agreement , including key informatics initiatives that ensure interoperability of testing data to improve patient care , local and national prevention efforts , and outbreak response .
Informatics Initiatives for a Changing AR Landscape
APHL has launched several important informatics initiatives to maximize data exchange across the AR Laboratory Network , with ongoing enhancements addressing emerging AR concerns and testing innovations .
“ The latest informatics features are helpful when working with CDC and our state AR Lab Network epidemiologist to help find and address gaps in our reporting ,” said Mary Anne Thomason , team lead for Public Health Laboratory IT Services at the Washington State Department of Health . “ I have been able to analyze and address data errors and have seen the number of errors reduced by half over a two-month period . We continue to make sure our data quality improves using AR tools ,” she stated .
Lab Web Portal
The Lab Web Portal ( LWP ) serves as an electronic test order and results ( ETOR ) web portal solution to improve multidirectional testing data between submitters and laboratories . Implementation of this platform reduces use of paper test orders and reports , which are error-prone and inefficient . LWP provides the ability for the AR regional laboratories to achieve a two-day turnaround time , improving response time for both direct patient care and outbreak investigations .
Data for Action on Antimicrobial Resistance Threats
The Data for Action on Antimicrobial Resistance Threats ( DAART ) repository is an interoperable platform for all state and local ELC-funded jurisdictions to submit testing result data to CDC . Access to robust , real-time data expedites the detection of AR threats in healthcare settings and the community , providing the information needed to coordinate containment efforts . “ DAART has become my ‘ go to ’ application to identify Health Level Seven ® ( HL7 ® ) message errors for the different AR programs ,” said Thomason . “ We can download , review and correct those errors on a daily , weekly and monthly basis . I particularly like the processing monitor view that shows me how many messages have been processed by program and if any messages had issues .”
HL7 ® Messaging
To leverage the power of standardized reporting , focused efforts are being made to modernize the mode of data exchange to HL7 ® messaging . HL7 ® provides data standards and ensures interoperability of data between systems . Increased adoption of HL7 ® messaging for the AR Laboratory Network allows CDC to receive data in a standardized format for higher quality and faster analysis .
Building for Expanded Testing and NGS
The AR Laboratory Network continues to strengthen diagnostic testing capabilities and leverage the use of new technologies such as nextgeneration sequencing ( NGS ) to better understand AR pathogens . Recently , the AR Laboratory Network expanded HL7 ® reporting capabilities to include NGS metadata to enable CDC to link sequencing results in the National Center for Biotechnology Information ( NCBI ) database to specimen information in DAART for surveillance of drug-resistant pathogens .
At the foundation of these initiatives is AIMS , a secure cloud-based public health data exchange platform . Collectively , these efforts lead to higher quality AR data , which bolsters disease tracking and trending , and guides intervention and resource needs .
Public health informatics continues to evolve with laboratory testing to leverage the functionality of electronic data exchange . Together , these efforts help prevent the spread of antinicrobial resistance and save lives . g
To support informatics efforts , APHL technical assistance specialists assist public health laboratories , public health agencies and other data exchange partners in the planning and implementation of data exchange solutions . For technical assistance , please contact informatics . support @ aphl . org .
This project was 100 % funded with federal funds from a federal program of $ 4,207,793 . This project and the production of this article was supported by Cooperative Agreement # NU60OE000104 , funded by the US Centers for Disease Control and Prevention ( CDC ). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of , nor an endorsement by , CDC , HHS or the US Government .
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