National Center for Public Health Informatics

1. CDC & CSTE Joint Electronic Laboratory Reporting (ELR) Task Force Workgroup Kickoff Meeting !! October 25, 2010 National Center for Public Health Informatics

2. Agenda • Welcome & Introductions • Review background of CSTE and CDC Joint ELR Task Force • History & Vision • CDC EHR MU Advisory Group • Workgroup Overview & Discussion • Workgroup charge & potential deliverables • Roles & responsibilities • Communications & Collaboration • Short-term timeline & Next Steps • Meetings & Participants • Workgroup Next Steps • PM Team Next Steps • Questions & Comments

3. History & Relevant Related Efforts • ELR’s importance has been recognized for over a decade • CDC and CSTE Joint Task Force formed in 2010 in response to CSTE’s 2009 Position Statement of 2009 Recommendations for the Implementation of Electronic Laboratory Reporting in the United States • ELR is one of the first three population health objectives for meaningful use of health information technology (HIT) under the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. • Public Health Laboratory Interoperability Project (PHLIP) – foster collaboration in the areas of information technology and laboratory science, with the immediate goal of developing, piloting and deploying viable IT architecture options and tools for the exchange of electronic laboratory data at all levels of public health laboratories.

4. CDC & CSTE Joint ELR Task Force Vision All labs (public and private) conducting clinical testing identify laboratory results that indicate a potential reportable condition for one of the jurisdictions they serve, format the information in a standard manner, and transmit appropriate messages to the responsible jurisdiction; all jurisdictions can and do receive and utilize the data.

5. Joint ELR Task Force • May 20-21, 2010, Atlanta, GA - The Electronic Laboratory Reporting (ELR) Task Force Steering Committee held its first meeting. • June 6, 2010, Portland, OR - The top 5 priorities developed from the ELR Steering Committee meeting were presented to and reviewed by CSTE membership and conference attendees on Sunday before the 2010 CSTE Annual Conference. • August, 12, 2010, teleconference – The Steering Committee refined and endorsed and refined work plan for ELR Task Force.

6. Steering CommitteeFive high level priorities • Develop a strategic plan for coordination between states, CDC and ONC • Develop, evaluate and endorse standards to reduce variation in what is required for ELR across the nation • Collaborate with APHL to compare and assure that PHLIP messages (formats, vocabulary, and transmission) and NEDSS messages are consistent and compatible to leverage the laboratory message infrastructure to communicate with clinicians, CDC, or state/local surveillance systems • Develop model state law for electronic laboratory reporting and make available for other states to adopt • Articulate exactly what resources are needed to implement state/local ELR through a needs/capacity assessment

7. CDC EHR Meaningful Use Advisory Group • The objective of the Group is to promote the interest of CDC and public health in national EHR/Meaningful Use efforts by: • identifying opportunities to engage with ONC and CMS on relevant public health measures • developing strategies for providing input and feedback from programs for all future stages for timely submission to ONC and CMS • coordinating with public health partners on feedback and potential impact, • providing training on Meaningful Use to CDC staff • participating on relevant HHS and national decision making bodies, particularly those related to certification and standards • identifying opportunities to fund public health activities that support and demonstrate meaningful use • developing public health strategies for alignment with future stages • facilitating the timely dissemination of relevant information to CDC and partner organizations.

8. Workgroup Overview & Discussion

9. Five ELR Workgroups • Establishing Value of ELR and Meaningful Use • Charged with developing a strategic plan for coordination and communication between states, CDC and Office of the National Coordinator for Heath Information Technology (ONC). • Co-chairs: Perry Smith (CSTE), Laura Conn (CDC) • Staff SME: SanjeevTandon (CDC) • ELR Standards and Management • Charged with evaluating and endorsing electronic data standards to reduce variation in what is required for ELR across the nation. • Co-chair: Rita Altamore (CSTE) • Staff SME: SundakGanesan (contractor to CDC)

10. Five ELR Workgroups, cont. • Model Law and Policy for ELR • Charged with developing model state law and policy for ELR and making it available for states to adopt or adapt • Co-chairs: David Blythe (CSTE), Fred Shaw (CDC) • Staff SME: TBD • Resource Needs/Capacity Assessment Workgroup • Charged with articulating what resources are needed to implement local/state ELR through a capacity assessment • Co-chairs: LauriSmithee (CSTE), Dan Pollock (CDC) • Staff SME: John Abellera (CDC) • LIS Vendors/Large Laboratories Workgroup • Charged with continuing the progress made with large laboratories to fully implement ELR as well as engaging LIS vendors on cost-effective solutions for states • Co-chairs: Tom Safranek (CSTE), Dan Jernigan (CDC) • Staff SME: ArunSrinivasan (CDC)

11. Roles & Responsibilities

12. Roles & Responsibilities, cont.

13. Communications & Collaboration • APHL has offered use of their SharePoint site • Proposing the following components: • Group announcements • Team Discussion Board • Shared documents • one folder per workgroup • one folder for taskforce • Site Users List • Links • Calendar • Workflow??

14. Timeline for Remainder of 2010

15. Next Steps - Meetings • Workgroup meetings • Generally by phone but can explore in-person meeting if needed • Some limited travel funds are available • Weekly to every other week based on need • Try to define regular meeting schedule • Recurring Staff SME meetings and/or Staff SME & Co-Chair meetings • Periodic Report-out meetings to task force • Meeting scheduling support from Monica and Kaley • Live Meetings • Bridge Lines • Room Scheduling • Agenda & Meeting Minutes

16. Next Steps - Workgroups • Additional Participants • CSTE has identified members • CDC is soliciting members • APHL to identify participants for specific relevant workgroups • Workgroups to do (2 weeks): • Identify gaps in membership • Recommend additional members • Identify private sector participants whose input should be included • Schedule workgroup kickoff meetings (work with Kaley/Monica) • Touch base with workgroup co-chairs, review/revise charge and potential deliverables, begin drafting work plan

17. Next Steps – PM Team Project Management Team to do: • Reach out to OGC for handling of private sector participants • Work with APHL to establish SharePoint • Provide templates & draft project plan to Staff SMEs • Determine processes • Document review – plan to use SharePoint, still working to define process (workgroup -> taskforce -> steering committee -> CSTE & CDC -> external)?? • Document clearance –determining if formal clearance is required before documents can be made available outside task force

18. Questions and Comments

19. Extra Slides

20. Commercial Clinical Labs State Public Health Labs Small Private Labs Patient Registry Hospital or Healthcare System What do we mean by Electronic Laboratory Reporting? • Electronic Laboratory Reporting (ELR) allows laboratories to report test results for reportable conditions through an automated and secure process • Meaningful Use – HL7 v2.5.1 ELR State or Local Health Department ELR STD Data Hepatitis Data TB Data

21. Establishing Value of ELR and Meaningful Use Potential deliverables • Model meaningful use definition for state’s use as related to ELR (state-defined meaningful use requirements for Medicaid incentives); • Describe health IT investments and meaningful use that may/will impact public health surveillance; • Policy/White papers describing the value of ELR public health (include deliverables 1&2); • Development of a strategic plan for public health to interface with ONC.

22. ELR Standards and Management Potential Deliverables • Establish a process for identifying and promoting standards including structure, vocabulary and terminology that are most suitable for public health; • Recommend how to best manage and reduce the information related to what is required for reporting for each jurisdiction to all laboratories; • Develop a core set of required data elements; • Investigate ways to share HL7 implementation guides accessible to public health;

23. ELR Standards and Management Potential Deliverables, cont. • Perform gap analysis between PHLIP and NEDSS messages and make recommendations regarding harmonization of vocabulary, structure and content; • Evaluate existing standard setting processes and determine if they are adequate for public health; • Establish an effective means of communication regarding what is required (diseases, format, timelines, data elements, etc.) for each jurisdiction to all laboratories to support and facilitate ELR from all reporters

24. Model Law and Policy for ELR Potential deliverables • Identify key issues that need to be incorporated into a model state law (potentially, privacy and security, shared use amongst jurisdictions, timely reporting of a lab result, etc); • Draft model law for wider circulation and input; • Disseminate final model state law to all jurisdictions; • Analysis of current state law and best practices for data sharing and articulate a data use and reciprocal data sharing agreement (DURSA) for sharing ELR across jurisdictions.

25. Resource Needs/Capacity Assessment Workgroup Potential deliverables • Develop metrics for ELR progress to increase the granularity and specificity of assessments of ELR progress; Describe health IT investments and meaningful use that may/will impact public health surveillance; • Identify state specific needs and assess technical assistance;

26. Resource Needs/Capacity Assessment Workgroup Potential deliverables, cont. • Assess the resource needs for ELR implementation (workforce, material resources, assessment of fixed and variable costs requirements, including training, for states and local jurisdictions; • Disseminate results of assessment to states and ELR Steering Committee; • Develop white paper depicting full ELR implementation and the steps required to reach full implementation; • Assess and identify sources of funding and resources for ELR implementation

27. LIS Vendors/Large Laboratories WorkgroupPotential deliverables • Develop a cost effective approach for vendors interfacing with the public health community; • Build on work with large national labs to ensure full implementation of ELR; • Get them to include the appropriate standards in their products prior to certification. • Identify incentives for LIS vendors to incorporate ELR capacity in their products and incentives for large labs to use ELR to report to public health