Background:
Traditional disease surveillance, which relies on hand-entry of paper laboratory results, may result in untimely documentation of incident disease and delay disease intervention activities. In 2004, the NYC Bureau of Sexually Transmitted Disease Control (BSTDC) received reports for >44,000 Chlamydia and gonorrhea cases, and >3,700 syphilis cases. Electronic Laboratory Reporting (ELR) was implemented in 2003 to streamline laboratory reporting and increase timeliness. By law, all laboratories testing specimens for NYC residents must report results electronically by July 2006.


Objective:
Describe the implementation of ELR and its impact on STD surveillance.

Method:
Key persons involved in ELR implementation and transition from paper-to-electronic reporting were interviewed to describe processes, challenges, and successes. Surveillance data were analyzed to quantify the impact of ELR.

Result:
Persons interviewed reported that considerable agency buy-in and upfront investment by programmers, implementers and data managers are essential for ELR success.
Close collaboration with laboratories' Information System (IS) staff was, and is, integral to ELR success. Individual laboratories have varied levels of IS support, are often unable to provide required reporting elements and frequently use non-standard methods to code test types.
As of July 2005, 52% (25920/50264, annualized) of Chlamydia and gonorrhea reports were received electronically. From 2003-2004 there was a 48% increase in Chlamydia reports and a 42% increase in gonorrhea reports sent to CDC within 30 days of specimen collection. Field investigations for reactive syphilis serologies were initiated a median of 6 days earlier for electronically received reports, compared to paper reports.


Conclusion:
ELR has improved the timeliness of BSTDC laboratory reporting and disease intervention activities. Considerable staff resources were dedicated to ELR implementation. Working with laboratories presents an on-going challenge. Ultimately, ELR should decrease resources needed for data entry.

Implications:
ELR can result in timelier reporting than paper-based systems and lead to faster disease intervention.