Electronic Laboratory Reporting for the Laboratory Response Network
CDC has modernized the data exchange infrastructure currently in place for the
Laboratory Response Network (LRN) due to several driving factors, including the need to consolidate and streamline services, the age of the current application used for LRN data exchange and the opportunity to leverage new and more advanced software technologies. After an intensive review of the LRN for Biological Threats Preparedness (LRN-B) and LRN for Chemical Threats Preparedness (LRN-C) was conducted in 2017, attention was given to the consistent application of vocabulary and messaging standards. A new standard was finalized in early 2018, which is compatible with electronic laboratory reporting (ELR) (ORU_R01 HL7 v.2.5.1 or ELR to Public Health) requirements consistent with other laboratory data reported to CDC, providing greater data interoperability and flexibility for LRN-B and LRN-C moving forward. ELR is now the desired method for member laboratory reporting to CDC.
ELR is a patient-centric system of reporting that uses a laboratory's existing Laboratory Information Management System (LIMS) to send data to CDC. The system applies to both LRN-B and LRN-C reporting and provides the highest quality data. To date, several LRN-B and LRN-C laboratories have completed the full scope of LRN ELR reporting requirements.
Benefits of ELR for the LRN
Reduces manual entry burden, which leads to fewer errors and better data integrity.
Streamlines data requirements so that less reporting is needed.
Maximizes data volume and quality during surge events, which enhances surveillance and preparedness capacity.
Minimizes implementation costs and maintenance burden, making ELR more sustainable.
In general, ELR has great benefits compared to Laboratory Information Management System integration (LIMSi) vocabulary. A smaller standardized data set means less data need to be maintained and mapped for reporting to the LRN. Utilizing a standardized ELR message in the LRN eliminates the need for anything special in a laboratory's LIMS structure as the vocabulary, structure and messaging reflects those used in other sections of the laboratory. This also eliminates the need for any additional maintenance and support for the LRN and should be considered as part the laboratory's messaging ecosystem as a whole for implementation and maintenance.
Funding Opportunities for LRN ELR
The costs for implementing ELR for LRN-B and LRN-C data integration capabilities varies depending on the LIMS platform. There are several funding options available for LRN ELR implementation:
The Epidemiology and Laboratory Capacity (ELC) Program | Epidemiology and Laboratory Capacity | CDC
Program A: Cross-cutting Epidemiology and Laboratory Capacity
Public Health Emergency Preparedness Program and Guidance | State and Local Readiness | CDC
Domain 6- Biosurveillance
Direct Funding via APHL: Funding is available on a first-come first-serve basis and is available to all LRN laboratories. Information regarding the application process is below. The funding can be used to cover laboratory and IT staff time, LIMS vendor costs and other implementation costs. Expenses that are NOT fundable include computer hardware and software licenses.
LRN-B and LRN-C laboratories should secure appropriate funding to transition to the ELR to Public Health standard for messaging LRN data to CDC. Additionally, laboratories should ensure that they have the funding necessary maintain this reporting mechanism. APHL recommends that states work with CDC to implement the necessary message structure for all LRN biological and chemical agents in support of electronic data exchange for the LRN-B and LRN-C.
Frequently Asked Questions
What is the application process for direct funding via APHL?
- Laboratories should email CDC's LRN Data Integration Team at
LRNITServices@cdc.gov to request more information about the funding opportunity. The email should copy or include a list of the staff that need to be included in future communications.
- Once the email is received, the CDC LRN Data Integration Team will provide the laboratory with a funding request package, which should be completed and returned.
- The funding packet will be reviewed and approved by CDC and APHL, and confirm the funding amount the laboratory will receive.
- Once approved, a subaward will be executed between APHL and the laboratory outlining the project timeline, scope of work/expectations and payment terms.
How long does implementation take?
Implementation time can vary but should be completed within 12 months. Laboratories will have regular check-in calls with CDC and APHL throughout the implementation process and will receive technical support from the data integration team.
What are the requirements for applying for ELR implementation?
Before ELR implementation can be initiated, laboratories must have the requisite infrastructure in place, which includes a LIMS system that is in a ready state. This means that other than routine maintenance or troubleshooting, the LIMS system cannot be changed or upgraded during the performance period. Additionally, the LIMS system should have a data messaging infrastructure. While an ELR-based messaging infrastructure is not required, it is preferred.
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