Practical Aspects of An Operational Open Source Notifiable Condition Detection System

Electronic laboratory reporting can improve surveillance for notifiable conditions.  Building on standards for message structure and content (HL7 and LOINC®), we have implemented and maintained an automated notifiable condition reporting system for the last 9 years in the Indiana Network for Patient Care, an operational health information exchange. The system receives real-time HL7 clinical results from a variety of health information exchange stakeholders, translates these disparate proprietary codes into LOINC codes, determines whether the results carried by the message indicates a notifiable condition by checking the abnormal flag sometimes contained in the message, or by comparing the test results with criteria in the PHIN notifiable conditions mapping table. With support from the CDC situational awareness initiative, we evolved our existing notifiable condition processor infrastructure to create a modular notifiable condition processor re-usable by other health information exchanges and public health stakeholders.  In May, 2009 we were pleased to deliver the Notifiable Condition Detector (NCD) version 1.0 and condition detectors for Shigella, Salmonella and MRSA as an OpenMRS module in both binary and source code formats. We will describe: (a) the minimum hardware and software requirements for implementing the NCD, (b) step-by-step instructions for installing and configuring the NCD, (c) operational features useful for the NCD system operator including reporting, monitoring tasks, and system configuration and administration, (d) information flow through the NCD, (e) methods for obtaining and contributing to the source code, (f) evaluation of the new system version, and (g) future directions for the NCD.