2. LA County Dept. of Public Health Pathology Data to Public Health - Intro Raymond Aller, M.D. Director, Automated Disease Surveillance Los Angeles County Department of Public Health 10 September 2007

3. LA County Dept. of Public Health 10 September 2007 2 The diversity of public health ….  Improving the public’s health, in a variety of ways  Takes the population point of view, rather than the individual patient  Ascertain – act - assure

4. LA County Dept. of Public Health 10 September 2007 3 The diversity of pathology  Surgical pathology – individual diagnoses via personal service  Clinical pathology – assuring usefulness of a variety of diagnostic and monitoring assays  Forensic pathology – why and how did they die?

5. LA County Dept. of Public Health 10 September 2007 4 For each subspecialty, a different way we can support public health …  Surgical pathology –Tumor diagnoses –Other findings of PH importance –Research findings: asbestos  Clinical pathology ** –Infectious diseases, toxic exposures, etc –Population patterns – antimicrobial susceptibilities, rate of test orders  Forensic pathology –Infectious diseases, toxins, etc. –Injury and violence prevention data

6. LA County Dept. of Public Health 10 September 2007 5 Electronic Lab Reporting (ELR)  Software on the laboratory information system automatically selects from all laboratory results, those which are reportable to public health  In other cases, ALL results transferred to a filtering system, that selects reportables  These may be enhanced by other findings of public health importance –Antimicrobial susceptibility testing –Syndromic indications  ELR commonly doubles the reporting rate

7. LA County Dept. of Public Health 10 September 2007 6 Benefits of fully automated Electronic Lab Reporting  More rapid transmittal of required reports  More complete reporting  Savings in lab staff time  More accurate transmission  Assured HIPAA compliance

8. LA County Dept. of Public Health 10 September 2007 7 Two different categories of data Public Health Disease Surveillance Identified disease cases Findings in large populations Case reports from Infection control practitioners, nurses physicians, others Diagnostic laboratory findings ELR vCMR Antimicrobial results Emergency department chief complaints Over the counter medications RODS Syndromic ELR Lab orders ELR

9. LA County Dept. of Public Health 10 September 2007 8 Data Transformation Hospital Systems Public Health Information System Public Health Information System Public Health Information System Web page Data entry Format converter De-identification (of “non-reportable” findings) Collation Text handling Routing PH compliant HL7 messages PH compliant HL7 messages PH compliant HL7 messages These functions may be performed in the Public Health Department, Data Producing Facility or an Intermediary Filter Code translation Code translations

10. LA County Dept. of Public Health 10 September 2007 9 How do I get my lab connected?  Talk with your local PH department –Are they ready to receive data? –What format/coding do they want?  Talk with the vendor of your lab’s Lab Information System –How to install their PH interface module? –Does it match the specs of your local PH? –Modules/capability available from Misys, Meditech, Cerner, SCC, Orchard, others soon

11. LA County Dept. of Public Health 10 September 2007 10 How else can we help PH?  We have a valuable skill set –Much pathology training also prepares one for PH –Not necessary to have specialized PH training to make a valuable contribution to PH

12. LA County Dept. of Public Health 10 September 2007 11 How can we contribute?  On contract or salary –PH laboratory director –Communicable disease (infection control) –Informatics –As Health Officer  As a volunteer –Especially in third world context

13. LA County Dept. of Public Health 10 September 2007 12 Questions? Follow up? Raymond D. Aller, M.D. raller@ph.lacounty.org 213-989-7208 I look forward to hearing from you.