Tactics for Implementing An ELR Hub

The Wisconsin State Laboratory of Hygiene (WSLH) serves as the state’s messaging hub for reportable conditions and other public health related data as part of its strategic plan.  Coordinating and implementing an ELR hub required developing tactics that could be used with a disparate set of laboratories, hospitals, clinics, and other health organizations, as well as internally and with affiliated state and federal health agencies.

The tactics employed by the WSLH were framed by a few key strategies and technologies.

• HL7 v2.3.1 would predominate as the exchange format of choice.
• Vendor provided solutions would be used by data producers and consumers.
• PHINMS would be used for transport.
• Technological and content issues would be resolved by the hub to minimize impact and costs for participating entities, and encourage participation.

Since the hub’s initial responsibility was to provide ELR to the Wisconsin Electronic Disease Surveillance System (WEDSS), the first tactical decisions were focused to that end, and included setting up lines of planned communications between WEDSS project managers, WSLH program staff, and the WEDSS vendor, and later expanded to include technical staff.  Issue tracking software provided by the vendor was used as a method of focusing discussion.

Similar lines of communication were set up between data producers (various labs, hospitals, etc) and the WSLH.  WEDSS project managers were included when needed. Technical staff directly communicated to establish PHINMS connectivity as an initial task.  Online instructions were provided to minimize interactions, particularly during configuration.

WSLH program staff analyzed producer’s data streams.  Any deficiencies were negotiated with both the producers and WSLH technical staff to determine how they could be best addressed. Data was routinely transmitted to the WSLH and continuously evaluated with incremental updates until the quality was sufficient for final evaluation by WEDSS project staff and production service.