PHLIP RnR Hub for ELSM& Beyond

ELSM October 25, 2010

•RNR Hub

•ELSM

•Pandemic Influenza

•Electronic Lab Reporting

The Plan

Florida RnR Hub Team

•Frans de Wet•John Butler•Jeff Couch•Eddie Gonzalez Loumiet

Uber Operations contractors to:

•Florida Dept of Health•Texas Dept of State Health Services•Assoc of Public Health Labs

Public Health Laboratory Interoperability Project

(PHLIP)

PHIN-MS Route-Not-Read Hub (RnR Hub)

• A National Resource: Information and laboratory scientists at the state and federal level addressing highly complex technical issues critical to public health.

• A Collaboration: commitment to utilize NHIN IT architecture options for the exchange of electronic laboratory data at all levels of public health laboratories.

• A Community: to support and expand LIMS user communities, creating a process that can be applied to other highly complex problems

• Products and Publications: Documentation of decisions made, fiscal and human resources needed, and lessons learned. Development and dissemination of Vocabulary and Messaging guides to meet the needs of the Public Health Laboratory “harmonized” list of LOINC and SNOMED codes for nationally notifiable diseases (NND’s).

• A Success: The realization of common goals and national priorities in a production environment.

What is PHLIP?

Achieve bi-directional laboratory data exchange

•State public health labs (SPHL) with CDC labs

•SPHLs with local partners

Which will

• Improve data quality and accessibility

• Improve data sources for active surveillance

•Develop and test future system approaches

•Create a Strengthened collaborative environment for public health

National Interoperable Laboratory System

PHLIP Vision

• National collaborative process

• Provide detailed vocabulary implementation guidelines

• Build PHL capability for electronic test ordering and result reporting

• Develop data exchange architecture options using the PHIN-MS

• Establish a process to help labs increase messaging capability

PHLIP Florida RnR Hub Team

PHLIP Building Blocks

• Public Health Information Network – Messaging System

• Provides public health applications a common platform for message transport

• Secure and reliable over the Internet

• Standards-based -“De-facto” standard for secure message transport

• Available at no cost to users

• Applications using PHINMS include: BioSense, ELR, LRN, NBS,NND, NHSN, LabCorp, PerSe, Foodborne, BSIO, PHLIP

• Used by Public Health Information Network Certification (PHIN)

• 7-year old product deemed “mission critical” by CDC

• Over 700 PHIN-MS nodes used in U.S.

What is PHINMS?

Multiple Senders to Multiple Receivers = exponential growth of connections and maintenance

Direct Send Model

RnR Hub

Solution

•The RnR Hub focuses on reducing the overhead of the PHIN-MS Direct Send model

•A PHIN-MS receiver is not required for bi-directional messaging

•Additional firewall configuration is not typically required for each Trading Partner – infrastructure needs are low

•Facilitates rapid implementation of electronic message exchange

•Low deployment costs for partners - Ability to send pre-configured install “package”

•Reduction of management burden

•Message routing

•Certificate management

•Hardware and bandwidth needs

•Once on the RnR Hub, you can exchange

Information with all others on the RnR Hub

•Centralized Support provided by the RnR

Hub Team

What is the RnR Hub?

PHLIP Use Case 1 – ELSMInfluenza – Electronic Laboratory Surveillance Message

• Goal: All states sending Influenza results via the PHLIP HL7 Message to CDC

• New states to complete readiness assessment and agree to PHLIP decisions

• All states to provide Influenza reporting metrics

• PHLIP Assistance Teams to deliver onsite and virtual support and PHLIP Program Management to provide oversight.

• Future: additional PHLIS agents as prioritized by CDC

State Public Health Lab

(SPHL)

PHLIP Route-Not-Read

Hub

CDC –Influenza Division

Message Format: HL7 2.3.1 ORU

Contents: Influenza Laboratory Results (WHO Global Influenza Surveillance Network)

HL7 Test Result HL7 Test Result

18 Labs In Production

State Public Health Labs

MaineMarylandMinnesotaMissouriNebraskaNew Mexico

ColoradoFloridaHawaiiIndianaIowa

AlabamaAlaskaArizonaArkansasCalifornia

Rhode IslandSouth CarolinaTexasUtahWest VirginiaWisconsin

Participants

2. Pandemic Influenza Project

3. Electronic Lab Reporting in Florida

& Beyond

•Exchange of influenza lab data with:

•Local partners

•Other states

•Federal partners

•International partners

•Exchange of lab test orders and results

•Develop surge capacity model for Pan Flu

testing

Pan Flu Project: Goals

DISTANCE from

Tallahassee to

AUSTIN = 868 MILES

• Chapter 64D-3 of the Florida Administrative Code

• Notifiable diseases and conditions

• Disease surveillance

• HL7

Electronic Lab Reporting

Data Transmission:

• sFTP

• PHIN-MS

• VPN

• Dedicated Circuit

Electronic Lab Reporting

• Register all state public health labs on the RnR Hub

• Continue to collaborate with Federal, State, and Local public health departments in addition to private health care providers and labs

• Begin work on additional use cases like Salmonella and the ETOR

• Continue development of the PHLIP architecture, with the expectation that the RnR Hub will serve as a connection to both the NHIN and the State Health Information Networks.

What’s Next?

Reusable Components

Teamwork

http://bit.ly/PHLIP-Info http://bit.ly/PHLIP-FLASH

http://bit.ly/RNR-1 http://bit.ly/RNR-2http://bit.ly/PHINMS

Additional Resources

Eduardo “Eddie” Gonzalez LoumietTeam Leader – FL RnR Hub

Uber Operations, LLCeddie@uberops.com

(850) 766 – 5338

Michelle M. MeigsManager, Informatics Program

Association of Public Health Laboratories8515 Georgia Ave. Suite 700

Silver Spring, MD 20910michelle.meigs@aphl.org508-494-5958 (mobile)

240-485-2771

Contact Information