The Integration of Electronic Laboratory Reporting and Case Surveillance Systems in New York State

The introduction of New York’s Electronic Clinical Laboratory Reporting System (ECLRS) in 2001 improved the timeliness of laboratory reporting, but also increased the case investigation workload for Local Health Departments (LHDs). Case investigators in the LHDs are required to transfer lab reports from ECLRS to New York’s Communicable Disease Electronic Surveillance System (CDESS) to generate case reports.  Integration of ECLRS and CDESS was needed to  minimize workload and expedite case investigation and  reporting. 

 An interface table was developed to link the lab result in ECLRS  to a case report created in CDESS.  The interface table contains keys from both systems and a process indicator field to denote the status of the record.  ECLRS information can be used to populate CDESS case reports as the LHD users transfer records from ECLRS to CDESS and initiate investigations.

 To further reduce the processing workload, a batch job can be run to automatically create case reports in CDESS from any lab report that has been received .  CDESS matches ECLRS lab results to any previously created CDESS case reports for the current surveillance period based on selected disease, first name, last name, county of residence and date of birth.  If there is an existing record that matches all criteria within the CDESS, the record is updated; otherwise, a new case report is created. 

 A dear doctor letter to ask for clinical information for each lab report can be automatically generated by ECLRS and mailed to providers.  A translation table of LOINC/SNOMED coded ECLRS lab results is designed to map test results received via ECLRS to a lab result row within CDESS.   CDESS allows users to minimize the keystrokes to generate case reports for core and supplemental information.

 This new automated process is being piloted for Lyme disease and may be expanded for other communicable diseases.   

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