By Lori Solomon, Editor, Diagnostic Testing & Emerging Technologies
National implementation of electronic laboratory reporting (ELR) continues to increase, according to a progress report published April 3 in Morbidity and Mortality Weekly Report. The authors predict that ELR might reach 80 percent of total laboratory report volume by 2016.
As part of the Affordable Care Act, the U.S. Centers for Disease Control and Prevention (CDC) has provided funds to 57 state, local, and territorial health departments to assist with implementation of ELR from clinical and public health laboratories to public health agencies. As an update to its previous 2013 report, the CDC examined regular electronic communications between the agency and the 57 health departments from 2012 to 2014.
The researchers found that as of July 2014, over two-thirds of the approximately 20 million laboratory reports received annually for notifiable conditions (67 percent) were received electronically, versus 62 percent in July 2013. Fifty-five of the 57 reporting jurisdictions received electronic reports, which came from 3,269 of approximately 10,600 reporting laboratories. The number of electronically reporting laboratories was up from nearly 2,900 in July 2013. The proportion of laboratory reports received electronically varied by jurisdiction, with six states receiving less than 25 percent, but 19 states and two large cities receiving 75 percent or more of reports electronically. These numbers represent an improvement compared to 2013 when the number of jurisdictions receiving more than 75 percent of laboratory reports electronically was 14 and nine jurisdictions received less than 25 percent of reports electronically.
LabCorp, Quest Diagnostics, ARUP Laboratories, and Mayo Clinic (defined as large commercial laboratories) accounted for 39 percent of the total ELR volume over the study period, while public health laboratories accounted for 23 percent. Hospital laboratories made up 20 percent of ELR volume. As of July 2014, 479 hospital laboratories were using the message format to report clinical test results required under the Meaningful Use incentive program. This is an increase from 200 hospital laboratories in 2013. Nationally, the CDC says, nearly 3,000 eligible hospitals have registered their intent to send electronic laboratory reports to public health agencies under the Meaningful Use program.
"National implementation of ELR continues to progress steadily, as evidenced by increases in both the number of laboratories using ELR and the proportion of reports being sent via ELR," writes co-author C. Jason Hall, from the CDC’s Division of Preparedness and Emerging Infections. "Two strategies that might be explored with large laboratories, and potentially others that report to multiple jurisdictions, are adoption of a single message that would be widely acceptable to public health jurisdictions and use of a hub as a single place to send to."
In the progress report, a small number of states report the impact ELR is having on public health practice.
- Iowa reports that ELR implementation has streamlined surveillance for reportable diseases and prevents diversion of staff or resources from other public health activities during outbreaks.
- North Carolina reports that ELR has decreased the time required for case processing by as much as 5 days (from when a case report is received by public health authorities to when it is submitted to CDC).
- Kansas reports that with ELR notifiable conditions are being reported 2.7 days sooner than when reporting was done via paper faxes.
- California says that utilizing a secure, statewide-integrated electronic disease reporting and surveillance system eliminates the need for local health departments to manually input laboratory reports. The state estimates 11,000 electronic reports are processed weekly.
For further discussion of the rise in electronic reporting of public health information and its impact, see the April 15, 2015 issue of Laboratory Industry Report.