Laboratory Information Management Systems (LIMS) and Electronic Laboratory Reporting (ELR) are a central vein of the public health data enterprise. Private and public laboratories collect and test samples from patients and the LIMS helps to manage these samples and their associated data. These systems can determine when a lab result is considered a reportable disease and generate an ELR to send to the public health agency for investigation.
Nationally, CDC encourages public health laboratories to maintain and enhance their LIMS systems to ensure ability to exchange data. Additionally, direct interfacing with lab testing equipment and implementation of electronic test orders and result reporting (ETOR) is strongly recommended as part of the Epidemiology and Laboratory Capacity for Prevention and Control of Emerging and Infectious Diseases (ELC) cooperative agreement as well as the ELC Enhancing Detection grant. ETOR is supported as part of CDC’s Public Health Data Strategy (PHDS), as it will help laboratories better forecast their needs because they will be able to see orders prior to receiving samples, with the goal of 100% of state public health labs having this functionality in place by the end of 2024.1
ELC funding also continues to support electronic laboratory reporting (ELR) activities, specifically to help jurisdictions achieve the milestone of receiving at least 75% of laboratory reports as ELRs. Additionally, CDC’s Public Health Data Strategy seeks to ensure that by the end of 2024, all ELC recipients are connected to at least ELR intermediary.2 The COVID-19 pandemic accelerated onboarding of ELR reporters and caused an explosion in ELR volume received. Prior to the pandemic, STLTs received about 30 million reports per year, but this inflated to nearly 50 million per month.3 To manage this volume, jurisdictions were forced to innovate by adding workflow decision support, automating processes, and splitting negative results off from feeds. Now, many STLTs have achieved high percentages of automated reporting, but are left to clean up some of the data quality issues that arose from rapid onboarding processes during the pandemic
“Electronic Laboratory Reporting (ELR) is in my opinion, an unsung hero of the COVID-19 response across the nation. The effort to implement ELR in states, localities and territories, began around 2006 with critical support from the CDC Epidemiology and Laboratory Capacity cooperative agreement that continues to this day. Laboratory results for critical diseases of public health importance now flow automatically to health departments, resulting in faster data available for public health response – however, this did not happen without the building of systems at laboratories and in health departments to send and receive the data, and many hours of hard work in states and local jurisdictions over the past 15 years. ELR is now in place in almost every state and territorial jurisdiction in the US. Without this capacity, public health would never have had information on all the people who were impacted by COVID-19, and would not have been able to respond, including understanding which communities were impacted the most, ensuring they knew how to protect themselves, had access to preventive measures such as vaccination and contact tracing, nor would states have been able to forward this information to CDC. This shows why investments in data infrastructure and the workforce (the skilled people who build and maintain it) are so important!”
Dr. Annie Fine, CSTE Chief Science and Surveillance Officer, Senior Advisor to Data Modernization Initiative