Direct Import of Electronic Laboratory Reports into Ohio's Disease Reporting System

The Ohio Department of Health (ODH) has added functionality to its online disease reporting system, the Ohio Disease Reporting System (ODRS), whereby HL7 2.3.1 formatted electronic laboratory reports are imported directly into ODRS with minimal manual intervention.  The HL7 Gateway, ODH’s enterprise-level real-time electronic laboratory report receipt and distribution system, directs electronic laboratory reports to the appropriate application based on the lab test code (either LOINC or local) in the report.  If the report is received by ODRS, several automated processes occur.  The data in the report are normalized; the patient, provider and facility addresses are geocoded to assign the report to the appropriate health jurisdiction; reportable disease is assigned, where missing, based on test result; and searches are conducted against existing ODRS data for both person and disease matches.  If a report has no person matches or has an exact person with or without disease match, it automatically populates ODRS and is available immediately to appropriate ODRS users at the local and state level.  Approximately 75% of electronic lab reports populate ODRS without user intervention.  User intervention is needed if the reportable disease cannot be identified from the test and result; the test code in the report is not mapped to an ODRS test name; or person with or without disease matches are close but not exact.  Some difficulties have arisen with this functionality, including managing electronic messages that do not exactly follow the HL7 2.3.1 specifications and dealing with receipt of test results that are not reportable (e.g., laboratory internal quality control testing).  Overall, though, this direct import of electronic messages into ODRS has been effective and well- received, improving completeness of disease reporting, reducing time lags in disease reporting, and reducing data entry.