Monthly Archives: March 2014

Electronic Laboratory Reporting and the Public Health Workforce

Roland Gamache, PhD, MBA
Senior Director, Informatics
NACCHO

An informative article in this month’s Online Journal of Public Health Informatics, “Estimating Increased Electronic Laboratory Reporting Volumes for Meaningful Use: Implications for the Public Health Workforce,” shows the value electronic laboratory results reporting can bring to the public’s health. The article also describes how electronic reporting can capture the large portion of communicable disease cases that go unreported to better contain the spread of those diseases, confirming the efforts of the Office of the National Coordinator for Health IT (ONC) and the impact of Meaningful Use activities towards achieving these goals.

More complete reporting through Electronic Laboratory Reporting (ELR) allows better prioritization of case investigation by public health, with increased focus on high priority/high impact diseases that pose the greatest threat to a community. This information allows health departments to investigate these events more rapidly and more efficiently, therefore preventing disease. According to Joseph Gibson, PhD, a co-author of this paper, “Without ELR, public health has been like a physician who only gets half of the test results ordered to determine how to treat a patient.”

Public health departments can better protect their community’s health because this information will provide public health practitioners with a more complete picture of the unmet need in the community. This level of information will allow agencies to prioritize their resources more efficiently and effectively.

ELR makes the act of understanding the disease burden in the community more efficient while requiring less time for hospitals and labs to provide information to public health departments.

Additional lab reports are an important part of case investigations. More complete case reporting creates a better picture of actual diseases circulating in a community. An influx in lab reports or more thorough case reports do not hinder case investigations, but strengthens them because they create a better picture of actual diseases that are circulating in the community, and also allows for a larger data bank that can be used for future public health studies.

Nor does ELR increase the amount of disease in a community; it just provides more information about the notifiable diseases. The resources needed by public health required to respond to these diseases are just better understood because this information is reported more often to health departments. If we do not have a clear picture of what is going on in the community, how can public health departments do their job and protect the community?

The National Association of County and City Health Officials and the Association of State and Territorial Health Officials have documented the resource constraints in health departments as highlighted in the article. However, health departments are working with local, state and federal partners to build capacity so they can capitalize on the type of data flow that is envisioned in the scenarios described by this article.

Similarly, ELR has increased efficiency for lab reporting, helping to ensure that electronic case submissions can increase efficiency. Case reports submitted by clinicians with complete information will reduce the burden on public health.

In summary, ELR will improve the health status of the community by allowing health departments to more effectively and efficiently deploy its resources to improve their investigations about the spread of disease in their jurisdictions.