rnr presentation to elr national working group
DESCRIPTION
Presentation by Eduardo Gonzalez Loumiet on the PHLIP RnR Hub to the ELR National Working Group on October 4, 2011TRANSCRIPT
PHLIP Route-Not-Read HubNational ELR Working Group | October 4, 2011
The Plan
• PHLIP• PHINMS• RnR HubsFoundation
• ELSM• Pandemic Influenza• ETOR Salmonella• Electronic Lab Reporting
RnR In Action
Florida RnR Hub Team• Frans de Wet• John Butler• Eddie Gonzalez
Loumiet
Nebraska RnR Hub Team• Jim Svoboda• John Glock
• Bob Williams
• PHLIP Assistance Teams
The Team
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 NwHIN 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 PHINMS
• 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)• 8-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 PHINMS Direct Send model
• A PHINMS 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 exchangeInformation with all others on the RnR Hub• Centralized Support provided by the RnRHub 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
2. Pandemic Influenza
3. ETOR Salmonella
4. Electronic Lab Reporting in Florida
RnR in Action
• 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
Use Case 2 – ETOR Service Requests
State to CDC – Electronic Test Order and Result
• HL7 Test Order from State Public Health Lab (PHL) to CDC Lab(s)
• HL7 Test Result from CDC Lab(s) to State PHL
• Limited Scope Production phase includes Salmonella and Bacillus anthracis
State Public
Health Lab (SPHL)
PHLIP Route-Not-Read Hub
CDC LabsSalmonella & BRRAT
Message Format:• Order = HL7 2.6 ORM
• Result = HL7 2.6 OUL
Contents: Salmonella & Bacillus Anthracis Orders and Results
Status: In progress
HL7 Test Order HL7 Test Order
HL7 Test Result HL7 Test Result
SPHL to CDC· Bi-directional Test Orders and Results· Designed to replace “DASH” form and
faxed results· Test orders directly from State LIMS
· Reduces Steps for Laboratorians· Increases quality of data,
immediate validation of order· Automatic confirmation of receipt
of order
· Test results directly from CDC LIMS· Automatic Update of State LIMS· Preliminary, Final and Amended
results· Increases quality of data· Faster turn-around
State Public Health
Lab (SPHL)
PHLIP Route-
Not-Read Hub
CDCSalmonell
aLab
HL7 Test Order
HL7 Test Order
HL7 Test Result
HL7 Test Result
• 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
• Continue to work on additional use cases like Salmonella
• Coordinate with the Public Health Laboratory Solutions and Solution Architecture (PHLISSA) project
• Continue developing interoperability between Direct and PHINMS
• Continue development of the PHLIP architecture, with the expectation that the RnR Hub will serve as a connection to both the NwHIN and the State Health Information Networks.
What’s Next?
Teamwork
http://bit.ly/PHLIP-Info http://bit.ly/PHLIP-FLASH
http://bit.ly/RNR-1 http://bit.ly/RNR-2
http://bit.ly/PHINMS
Additional Resources
Eduardo “Eddie” Gonzalez LoumietTeam Leader – Florida RnR Hub
[email protected](850) 766 – 5338
Contact Information