Data Sharing and Communication in Massachusetts

Transcription

1 Data Sharing and Communication in Massachusetts Emily Harvey Tracy Stiles Massachusetts Department of Public Health State Laboratory Institute September 20, 2011

2 Tools to Streamline Communication LIMS-IML talks to BioNumerics, ELR, MAVEN, CDC ELR MAVEN WGFIC Face-face discussions

3 SLIS LIMS & ELR FUNCTIONS & COMMUNICATION SLI CDC DMZ LIMS Users BtB PHINMS Internet Providers & Remote Users Providers & Remote Users LIMS Users IML Provider Information ( XML PRM message T1 Communications Internet Rhapsody Requests (XML ORM Message) Verified Results (HL7 XML ORM Message ELR External Router LIMS Users SLI Reporting Stations PE LIMS Users SLI Reporting Stations LIMS MAJOR SYSTEM FUNCTIONS ALL HARDCOPY REQUESTS & BAR CODE PRINTING LAB FUNCTIONS WORKCARDS WORKLISTS RESULT ENTRY RESULT VALIDATION AND VERIFICATION QC INFORMATION QUIRE / EDITS MANAGEMENT REPORTS COMMUNICATE REQUESTS AND RESULTS TO ELR ELR MAJOR SYSTEM FUNCTIONS PATIENT REPORTS HARDCOPY ELECTRONIC TRANSFER OF RESULTS TO PROVIDER SYSTEMS AND CD GENERATING LOINC AND SNOMED CODING PROVIDER INQUIRY VIA PORTAL FOR RESULTS AND REPORTS ELECTRONIC TRANSFER OF REQUESTS FROM PROVIDERS SYSTEMS TO LIMS New Providers and Provider Updates to LIMS maven

4 LIMS Integrated Microbiology Laboratory (IML) the enteric piece Data entered by analysts in the lab Capture name, address, dob, date of collection or subculture, pathogen suspected, Bench Tech records biochemicals and serogroup, serotype info Final result sent to verification Supervisor reviews demographic data and test results Releases result

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7 The State Laboratory Information System (SLIS) Access Database SLIS Application PE LIMS LabWorks LIMS ODBC Link BioNumerics Laboratory Information System (LIMS Component) STD, IML, BtB (STD, Viral Serology, HIV) IML JAVA/ORACLE BtB.NET/ SQL Electronic Laboratory Communications and Reporting (ELR) Component

8 Electronic Laboratory Communications and Reporting (ELR) Component What is Electronic Laboratory Reporting? The Electronic Laboratory Reporting (ELR) in use at Massachusetts Department of Public Health (DPH) State Laboratory Institute (SLI) has two major modules. Electronic Laboratory Reporting of results preformed at State Laboratory Institute (SLI) to requesting facilities (hospitals, physicians, clinics, etc.). Send electronic test requests to SLI Receive electronic test results from SLI Search for results electronically and print hard copies of test reports Over 50 providers on system Electronic Laboratory Reporting of Communicable Diseases from local and hospital laboratories to state electronic laboratory reporting databases. Send in reportable disease notifications electronically

9 Electronic Lab Reporting (ELR) All results are sent to ELR after being verified Clinics/hospitals can access reports and print them locally No more mailing out big stacks of reports! Not all providers are there yet

10 ELR (continued) Finalized reports feed directly into maven Epis can look in ELR to see orders pending but not yet finalized Providers can look and see orders pending not yet finalized No more phone calls did you receive?

11 Future Plans for ELR Expand ELR to ELO(rdering) 1 hospital can do this already for TB Minimizes data entry errors by SLI staff! Expand ELR so results dump directly into local labs EMR These plans are more costly and require more work to set up Labs have to configure their systems to accept our results, not the other way around

12 HOW ELECTRONIC LABORATORY REPORTING (ELR) WORKS SLI Client Site SLI Reportable Diseases Reportable Diseases Reports ELR INTERNET Reports Specimens and Test Request Forms

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16 What is MAVEN? MAVEN: Massachusetts Virtual Epidemiologic Network (integrated disease surveillance and case management system)

17 Pre-Integrated Pre-Integrated Surveillance Surveillance Infrastructure: Infrastructure: Data Data Flows Flows Pre-Integrated Surveillance Infrastructure: Data Flows Hospital Public Health Laboratory Reference Laboratory CDC Provider Laboratory Fax Fax EDN Feeds time delay and duplicate data entry time delay and duplicate data entry Local Health data entry case investigation time delay and duplicate data entry time delay TB EPI and IMM STD RIHP data entry case investigation analysis Foodborne CDC

18 Benefits of MAVEN Benefits of MAVEN Complete data capture in single integrated system across BID standardized case investigation materials for all users (case report forms, Event Classification and data entry manual) simplification of case management of coinfected individuals contact and outbreak investigations and partner services activities made easier notes and attachments (labs, medical notes, etc) implementation of national data standards Integration with ELR and EMR efforts reduce manual efforts ability to automatically receive negative results, as appropriate Real-time information sharing

19 Benefits of MAVEN Configurable to respond to epidemiologic change Efficiencies automate triage of information to increase efficiency co-infection links automatic letter generation workload management More robust data analysis capability custom reports full data extracts opportunities for co-infection analysis Developed QA protocols: mechanisms for deduplication and address verification and geocoding reports for data entry checks, notifications, electronic laboratory reporting, audit trail

20 Integrated Surveillance Infrastructure: Data Flows Hospital Public Health Laboratory (SLIS) Reference Laboratory CDC Provider Laboratory Emergency Dept EDN Syndromic Laboratory Reports real-time electronic reporting (HL7, LOINC, SNOMED) EMR immediate diseases USERS MDPH Local health Providers (pilot) MAVEN Disease Surveillance and Case Management System MODULES TB EPI/IMM OMS Foodborne Deidentified RIHP STD (not HIV/AIDS) real time information sharing data standards/ PHIN compliance quality control/ quality assurance case investigation and case management cluster identification/ outbreak management analysis PHIN-MS reports to CDC MMWR

21 What if we have a cluster of matches? Lab ID s matches (usual route) Creates line list Post to shared drive Notify epi via that we have a cluster

22 Show line list, to eh

23 Sample From: Hussin, Ayman (DPH) Sent: Thursday, July 09, :10 PM To: Harvey, Emily (DPH) Subject: S. typhimurium JPXX (0905PAJPX-1) Hello, We have 3 matches to PA cluster S. typhimurium JPXX (0905PAJPX-1). Second enzymes are pending. A cluster sheet has been made and uploaded. Thanks Ayman Hussin State Laboratory Institute 305 South Street Jamaica Plain, MA tel: Ayman.Hussin@MassMail.State.MA.US

24 Our Best Tool Old School Division of Food Protection Working Group on Foodborne Illness Control (WGFIC) Division of Epidemiology Division of Diagnostic Laboratories

25 Maintain a Foodborne Illness Surveillance System Record complaints use FBI complaint worksheet! send a copy of these reports to the FPP log all reports electronically or on paper Investigate all reportable enteric illness contact each case complete case report form send forms to MDPH

26 WGFIC

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33 Future Plans Fully integrate WGFIC as a module in MAVEN Develop Outbreak Management use Incorporate all local health departments

34 Questions?