1. ELR Technical Assistance Current-state and Case Studies June, 2012 CSTE Annual Meeting Wesley R. Kennemore, MD, MS, PE, Assoc. of Public Health Laboratories. 205-937-1211, wes.kennemore@aphl.org

2. ELR Programs at APHL Informatics Two ELR programs – LTIAPH – ELRTA LTIAPH: ELR 251 and MU focused; assists Public Health Lab and Public Health Agency(Epi) ELRTA: Broader ELR assistance includes commercial labs, potentially hospitals; support other ELR formats (ELR 231, ELR 23z etc.) Overlap period CSTE 2012 Overlap period

3. Tools of the trade ELR implementation specific tools in the tool kit Collaborative work-group model to develop common tools Support ELR 251 and earlier formats (ELR 231 and ELR23z) Catalog of service offerings to suit the needs of jurisdiction Develop Position Statements clarifying Meaningful Use requirements CSTE 2012

4. Key Points Offer remote and/or on-site assistance based on the assessment Provide service offerings only (and not Hardware, Software) Knowledge transfer key priority of assistance model Organize ELR workgroups and facilitate ‘working- sessions’ Conduct Webinars for knowledge dissemination Simple TA request process – submit standard TA request form to CDC CSTE 2012

5. High Level ELR TA Categories CSTE 2012 Two High-level ELR categories – Enable ELR with a partner – Enable/Enhance ELR capability at Public Health Agency Partners – Public Health Lab – Commercial Lab – Hospital Lab

6. 1.ELR TA Requests currently being worked on by APHL Informatics team 2.Bulk of requests are from PHL. Typically PHLs handle more conditions and complex tests. 3.These are through ELRTA process (and not LTIAPH) CSTE 2012 ELRTA Active Requests (High Level view)

7. ELRTA Active Requests (Details) VA ME, VA AR, VA, MS, VT, NV, CT, NY City, OK KS KS, NC, ME MN, CT KS, MD, AR MD OK CSTE 2012

8. Examples – Arkansas TA Request PHL  PHA: A comprehensive end-to-end implementation PHA(Receiver) – Build ELR test environment – Enable ELR251 receiving capability – Integrate with their NBS – Framework to integrate with other program areas (TB, STD, Lead) PHL (Sender) – Build from ground-up – Data extraction from LIMS – Filtering of reportable conditions – Transformations of local codes to standard codes (LOINC, SNOMED) ELR CSTE 2012

9. Examples – Arkansas TA Request (continued….) HL7 Messaging Vocabulary/terminology Technical Architecture Design Hepatitis B Pilot (in production mode) for a short period Pilot Extend to more reportable conditions Scale incrementally CSTE 2012 Note: Messaging standard - ELR 251 (HL 2.5.1. ORU; ONC specified ELR 251 Implementation Guide) Implementation Approach

10. Road map Strategy…. Leverage this solution at VT and build/enhance further Bring the enhancements back to AR Examples – Arkansas TA Request (continued….) CSTE 2012

11. ELRTA Recipient’s Experiences Hear from your peers VA DOH – Pioneer in ELR space – Requests spanning a diverse ELR partners (PHL, Regional Commercial lab and Critical Access Hospital) KS DOH – Started the journey – Piloting with big commercial lab CSTE 2012

12. Resources ELR one pager Implementable Profile (HL7 2.5.1 ORU) Position Statement clarifying LOINC, SNOMED For more information contact – wes.kennemore@aphl.org OR wes.kennemore@aphl.org – Linda.Cohen@aphl.org Linda.Cohen@aphl.org CSTE 2012