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Standards for Public Health Laboratory (PH-Lab) Data Exchange

To foster awareness, partnerships, and collaboration at the local, state, and national levels in developing Health Information Technology (HIT) standards for public health laboratory (PH-Lab) information exchanges with clinical Electronic Health Record Systems (EHR-Ss) and public health surveillance systems; and to enable the integration of laboratory information systems to meet the health data needs of public and private organizations, agencies, and individuals, the PHDSC and the Association of Public Health Laboratories (APHL) worked with the standards development organizations - Health Level Seven (HL7) and Integrating the Healthcare Enterprise (IHE) - to develop base and interoperability health information technology (HIT) standards and their testing methods and tools.

The goal of the project was to enable real-time electronic information communication between laboratories, public health agencies and clinicians by operationalizing the HIT standards that already exist for laboratory information.

For this project, PHDSC developed CDA templates for laboratory reports for 17 conditions. The conditions include:

  • Anthrax (Bacillus anthracis)
  • Campylobacteriosis
  • Chlamydia (Chlamydia trachomatis)
  • Diphteria
  • Gonorrhea (Neisseria gonorrhoeae)
  • Hepatitis (B & C)
  • Influenza
  • Lead (Blood Lead)
  • Measles
  • Pertussis (Bordetella pertussis)
  • Respiratory Syncitial Virus
  • Salmonella
  • Shigellosis
  • Staphylococcus
  • Tuberculosis (Mycobacterium tuberculosis)
  • Tularemia (Francisella tularensis)
  • West Nile Virus

The templates were organized by single, preliminary and updated reports, as well as result types - simple numeric, simple titer, and a simple coded, panel results and culture results.

One single report was fully annotated with an explanation of why the element was populated, and how it would map to an HL7 v2.x message, if possible. The preliminary and updated reports were annotated where they differ from a single report.

As part of the project, PHDSC updated the generic CDA stylesheet file to allow for automatic population of specimen ID and report status (Preliminary or Final).

The process of creating these reports identified issues with the National Institute of Standards and Technology (NIST) validation tool for IHE's Sharing Laboratory Reports (XD-Lab) Profile, which have been resolved. The annotated templates have been shared with IHE Lab Committee for improvement.

For more information, please visit project wiki pages at https://wiki.phdsc.org/index.php/PH-Lab