Better, Faster Lab Reports Help States' Outbreak Response

Once labs detect dangerous infections, its crucial for the correct information to get to health departments quickly and in a format that allows them to recognize disease outbreaks. The Centers for Disease Control and Prevention (CDC)'s efforts to speed this process and ensure that the best and most complete information about disease cases is reported is paying off, according to new data released in todays issue of Morbidity and Mortality Weekly Report (MMWR).

A key to speeding lab reports is widespread adoption of electronic laboratory reporting (ELR) by the approximately 10,400 labs that send reportable data to health agencies. ELR is an important tool that gives health officials vital information on infectious disease cases. Since 2010, CDC has provided funds to help 57 states, local and territorial health departments increase the use of electronic laboratory reporting (ELR). 

The MMWR report shows that the number of state and local health departments receiving electronic reports from laboratories has more than doubled since 2005, when CDC last evaluated ELR reporting. In the past year, the number of individual reports received electronically increased by 15 percent. States and local health departments now estimate that nearly two-thirds (62 percent) of total lab reports were received electronically. The number of reports received through ELR varied by jurisdiction, the types of labs reporting and by disease reported.

Infectious disease outbreaks will always be with usand rapid recognition of an outbreak saves lives, says CDC director Tom Frieden, MD, MPH.  Thanks to electronic laboratory reporting (ELR), were detecting outbreaks faster than ever.  Unfortunately, only a quarter of the 10,000 labs across the country use ELR.  We must keep expanding use of ELR to help CDC and our partners save lives and reduce healthcare costs.

Electronic laboratory reporting can give health officials better, more timely and complete information on emerging infections and outbreaks than they have ever received before, says Robert Pinner, MD, associate director for surveillance, programs and informatics in CDCs National Center for Emerging and Zoonotic Diseases. Implementing these systems is a complex task that requires substantial investment, but ELR will provide health departments the tools they need to quickly identify and respond to disease threats and monitor disease trends now and in the future.

More work remains to be done to get more labs reporting electronically and to increase the percentage of reports that are made electronically. The MMWR report shows that only about a quarter of the nations labs are reporting electronically. And ELR for some diseases lags behind others. For example, 76 percent of reportable lab results for general communicable diseases were sent via ELR, compared to 53 percent of HIV results and 63 percent of results for sexually transmitted diseases.

Significant federal funding through the Office of the National Coordinator for Health IT is dedicated specifically to assisting providers and hospitals in adopting and effectively using Health IT, including ELR. ELR reporting by hospitals is likely to further accelerate starting in October 2013 when it will be required in order for hospitals to receive incentive payments.

The advances in ELR implementation have been accomplished through funding from the Prevention and Public Health Fund of the Affordable Care Act, distributed through CDCs Epidemiology and Laboratory Capacity (ELC) cooperative agreement. Through the ELC platform, CDC provides funding to all 50 state health departments, 6 local health departments (Los Angeles County, Philadelphia, New York City, Chicago, Houston, and the District of Columbia), Puerto Rico, and the Republic of Palau. Grants provided through ELC help pay for epidemiologists, lab technicians, and health information systems staff.

Speeding the nations response to infectious disease outbreaks is part of the CDCs ongoing 24/7 work to connect state and local health departments across the U.S., recognizing disease patterns and making state responses to health problems more effective. Increasing ELR is only part of CDCs effort. The Presidents 2014 budget would provide $40 million for the CDCs advanced molecular detection (AMD) initiative. AMD allows laboratories to identify infectious agents in a fraction of the time it takes using the decades-old technology still in use at most labs. Through the AMD initiative, CDC will be able to build critical molecular sequencing and bioinformatics capacities at national and state levels.

For more information on CDCs ELC cooperative agreement, visit http://www.cdc.gov/ncezid/dpei/epidemiology-laboratory-capacity.html.

Source: CDC