Lab Matters Summer 2019 - Page 14

INFORMATICS AR Lab Network Benefits from APHL’s ETOR Solution by Laura Carlton, senior specialist, Informatics and Rachel Shepherd, specialist, Informatics In 2016, the US Centers for Disease Control and Prevention (CDC) launched the AR Lab Network to help address the immediate need for a coordinated response at local and national levels to the rising number of antibiotic resistant (AR) pathogens. This initiative links public health laboratories with submitters—such as hospitals—and CDC epidemiologists through a comprehensive technical infrastructure. The AR Lab Network enables important AR test result data to be exchanged quickly to ensure a timely response and immediate intervention when positive cases are identified. APHL has helped lead this effort by developing technical solutions and secure infrastructure that makes the network possible by employing electronic test order and result (ETOR) capabilities on the AIMS Platform. How it Works Seven state public health laboratories have been designated regional laboratories responsible for specialized AR testing. For example, when a hospital suspects an antibiotic-resistant pathogen and sends the request to their local laboratory for testing, that lab will send the sample to their designated regional laboratory. The local laboratory enters the test request electronically through a web portal, which is received at the AR regional laboratory. The laboratory is able to access the request in real-time and make necessary preparations to receive the specimen. Once testing is complete, results are uploaded to the portal and are accessible to the submitter in real-time. Five regional laboratories are using the Lab Web Portal, APHL’s ETOR solution developed by iConnect Consulting and hosted on the AIMS Platform, and two are using their own home-grown portal solutions. Each laboratory is able to configure the Lab Web Portal to their specific testing workflow and data needs. technical infrastructure is designed so those same results can be automatically reported to CDC by the regional laboratory, reducing the reporting burden on laboratory scientists. What’s Next As regional laboratories and submitters began using the Lab Web Portal, APHL collected feedback from users to understand functionalities that would continue to improve ETOR and any challenges users were experiencing. Based on that feedback, APHL is currently rolling out the next version of Lab Web Portal, with some exciting new capabilities. Version 2 introduces LIMSConnect, a new function that allows the portal to sync directly with the laboratory’s information management system (LIMS). This seamless integration eliminates the need for the regional laboratories to set up HL7 messaging for test orders and results, which can be an onerous development task. The sync function establishes a direct line of communication from submitter to LIMS, and reduces the potential points of error or failure that can slow down the data transfer. From kick-off to production, it has taken approximately eight months to fully onboard regional laboratories using HL7 messages and enable them to achieve ETOR capabilities with their submitters. Using LIMSConnect, laboratories will be able to stand up ETOR for new pathogen testing faster and with less resource time compared to HL7. Other features that will benefit submitters include the ability to upload batch test orders and track the status of orders. When hospitals or laboratories have multiple tests that need to be processed, they will be able to enter several requests in one submission rather than create a single entry for each one, which will save data entry time for submitters. Currently, the Lab Web Portal notifies the submitter when the test order is received and when the result is ready. In the next iteration, submitters will be able to view the status of the tests performed throughout the testing lifecycle. ETOR is quickly becoming a fundamental capability for public health laboratories. Some AR Lab Network regional laboratories are expanding their Lab Web Portal solution beyond the network testing area with the goal of encompassing all test ordering and resulting across the laboratory, streamlining processes for labs and their submitters. APHL is ensuring that new enhancements and functionalities within Lab Web Portal can be applied, regardless of the type of testing or lab area, so the portal acts as an extension of LIMS rather than a one-off solution. The sooner labs can receive and process test orders, the faster they can turnaround critical test result information, ultimately leading to better patient care. n Through ETOR, the regional laboratory is able to meet the mandated 48-hour turn- around time to report test results back to the submitter. The AR Lab Network 12 LAB MATTERS Summer 2019 PublicHealthLabs @APHL