1. Robert W. Pinner, M.D. June 4, 2012 Update on ELR in the U.S. 2012 CSTE Annual Conference Omaha, Nebraska

2. 2  CSTE – APHL – CDC ELR Task Force  Prevention and Public Health Fund (PPHF) of the Affordable Care Act (ACA) has provided resources and focused attention.  ELC ACA funding (approximately $15 M for ELR and related work)  Communications, Implementation Support & Monitoring  ELR Technical Assistance Update on ELR in the U.S.

3. ELR Implementation Support and Monitoring Purpose 3

4. ELR Monitoring Process Current Step 4

5. ELR * in ELC Jurisdictions 5 RI AK WA OR CA MT ID WY NE NV NM TX AR TN ME VT NY FL GA AL NC VA MI PA NJ DE NH CT MA HI AZ LA OK KS CO UT SD MN WI IA MO IL WV MS KY OH IN MD SC Receiving ELR any format =51 (45 states, 6 cities) Not Receiving ELR =6 (5 states, 1 territory) ND DC NYC LAC HOU CHI PHI L N=57 PR * Production ELR for 1 or more conditions for 1 or more labs via any messaging format or direct web entry; MS is testing ELR;

6. % of Lab Report Volume Sent via ELR 6 RI AK WA OR CA MT ID WY NE NV NM TX AR TN ME VT NY FL GA AL NC VA MI PA NJ DE NH CT MA HI AZ LA OK KS CO UT SD MN WI IA MO IL WV MS KY OH IN MD SC ND DC NYC LAC HOU CHI PHI L PR Unknown Total of 7 (7 states) ( vol was reported but incomplete ) > 75% Total of 7 (6 states, 1 city) 50 – 75% Total of 13 (12 states, 1 city) 25 – 49% Total of 10 (9 states, 1 city) < 25% Total of 15 (11 states, 1 territory, 3 cities) No Data Total of 5

7. 7 Estimated National Status of ELR

8. Step 3: Volume of Lab Reports and % via ELR, by Disease Category N=42 8 # of Lab Reports for 12 month period

9. Steps 1 & 3: ELR Volume and Total Labs By Lab Type 9

10. Step 2: ELR Production Formats Supported N=57 10 # of Jurisdictions

12. ELR Technical Assistance 12 CDC made ELR Technical Assistance (ELR TA) available –Began receiving requests in Winter 2011 Delivered by Skilled Personnel (through APHL) Project (request) requirements: –Advances ELR Implementation –Well-defined –Relatively short in duration (1-4 weeks) Evaluation Criteria: –ELR from PH lab to PH agency –New, high volume ELR into the PH agency –Enables consumption by a surveillance system –Enables broader adoption of ELR in jurisdiction –Leverages work already done for other jurisdictions

13. “Current” ELR Technical Assistance Activities Technical Assistance Metrics Received 45 Request Representing 22 Jurisdictions Status: 1 - Completed 8 - Work Underway 10 - Detailed Scoping Began 18 - In Queue 8 - Out of Scope/Closed

14. ELR TA – Current Examples PH Lab to Arkansas Department of Health –Working with Arkansas PH lab to map LOINC and SNOMED codes for the reportable conditions ELRs. Regional Lab to Virginia Department of Health –Assisting Solstas, a regional lab that provides reports to parts of Virginia, North Carolina, Georgia, Alabama and Florida, with mapping of LOINC and SNOMED codes as well as the implementation of Rhapsody Connect. Large Lab to Kansas Department of Health –Kansas will be implementing their 1 st ELR feed from any lab with LabCorp. Assisting them with the receipt, routing and validation of the messages using Rhapsody. 14

15. Task Force overview Organization and membership Products and Activities CSTE/CDC ELR Task Force Website

16. Robert W. Pinner, M.D. June 4, 2012 Update on ELR in the U.S. 2012 CSTE Annual Conference Omaha, Nebraska