This section answers frequently asked questions about support of the Public Health Laboratory Interoperability Project (PHLIP), Electronic Laboratory Surveillance Message (ELSM) for Influenza, Vaccine Preventable Diseases, Electronic Laboratory Reporting (ELR) and other informatics topics.

Laboratories can also take advantage of the list of external resources on the Informatics Resources page.

Click on a question below for the answer.

PHLIP ELSM for Influenza and VPD

What is the process for adding a new flu strain to our ELSM?
Laboratories can consult the PHLIP encoding guidelines for seasonal flu strains. If laboratories need to add a novel flu strain or a new test mid-season and vocabulary does exist in a standard code set (i.e., LOINC or SNOMED), the lab can notify the PHLIP team. Through the CCB process, we will create a novel PHLIP code and distribute it via PHIN VADS. Once added to the standard code set, the standard code will replace the PHLIP code.
Where can I get a copy of the PHLIP Message Guide and the Encoding Guideline for Influenza?
The Message Guide, the Encoding Guidelines, and a list of deprecated codes are available on the PHLIP Production Support site. The Encoding Guidelines and deprecated codes are updated every six months.
How often do I need to update my laboratory’s ELSM for Influenza Message?
Updated encoding guidelines and deprecated codes are released every six months. Laboratories should update their code list for the PHLIP ELSM at least once a year to include new flu strains and remove deprecated codes before the start of the new season. Laboratories can continue to use deprecated codes for the remainder of the flu season, but not into the new season, provided the codes have been deprecated for at least six months. Use of deprecated codes after the prescribed grace period is not permitted. The Encoding Guidelines and a list of deprecated codes are available on the PHLIP Production Support site. Users can look up alternative codes in PHIN VADS to replace deprecated codes.
Our laboratory is in the process of upgrading or changing our LIMS. How will this affect the ELSM?
If your laboratory is planning any major changes to its technical architecture or information management system, be sure to let CDC and the PHLIP team know your plans as soon as possible. They will work with you to re-validate the ELSM once the implementation is complete.
How do I access the Daily Logs?
CDC logs all ELSM sent from participating PHLIP laboratories to CDC. CDC posts these logs to the PHLIP Production Support site on a daily basis. Participating laboratories should check the daily logs at least once a week to ensure that the CDC has received and processed all of the ELSM that the laboratory has sent.
What is the PHLIP Production Support site and how do I gain access?
The PHLIP team posts ELSM for Influenza resources for participating PHLIP laboratories to the PHLIP Production Support site, a SharePoint site maintained by APHL Informatics. Posted resources include the PHLIP Encoding Guidelines, a list of deprecated codes, and daily ELSM logs. Every participating laboratory should have at least two users with access to this internal APHL site. If someone at your laboratory needs access to this site, email informatics@aphl.org, or submit a request directly through the APHL SharePoint site.
We are having trouble with our Influenza ELSM. What should we do?
If your laboratory is in full production with the PHLIP ELSM for Influenza and you are experiencing problems with the data feed, first try to identify the problem using the simple checklist below.
Pyrosequencing: Enhancing the ELSM for Influenza
Several state laboratories have opted to add pyrosequencing data to the ELSM for Influenza. This additional information aids CDC epidemiologists in flu surveillance. To get involved, contact the CDC Influenza Division.
The Change Control Board (CCB): what is it, and how do I get involved?
The Change Control Board is made up of CDC representatives, APHL subject matter experts, and participating laboratorians from across the country. Its members vote on changes to the vocabulary and structure of the PHLIP ELSM. For Influenza the CCB meets once a month or as needed. Meeting notes and active issues are available to members on the internal CCB for Influenza site. For VPD the CCB meets as needed. Meeting notes and active issues are available to members on the internal VPD CCB site (To be set up so update this link, once completed). To get involved, email informatics@aphl.org.

Other Questions

What is the HL7 v.2.5.1 Implementation Guide: ELR to Public Health, and what is the difference between Release 1 and Release 2?
This guide, used in conjunction with the S&I Framework Laboratory Reporting Initiative (LRI) guide, contains the necessary specifications for laboratory results reporting to local, state, and federal health agencies, including messaging content and dynamics related to the transwermission of Reportable Laboratory Result Messages. The message described in this guide is not specific to any pathogen or reportable condition and is applicable for most biological and chemistry laboratory-reportable findings and can be constrained further by local jurisdictions depending on their reporting requirements.
Release 1 is the guide named in Meaningful Use (MU) Stage 1 (2011) and Stage 2 (2014). A free copy of the guide and its related errata and clarification documents are available from HL7: http://www.hl7.org/implement/standards/product_brief.cfm?product_id=98
Release 2 is currently proposed for voluntary certification in 2015, but it is NOT the version currently in use for Meaningful Use certification in 2014. To obtain a copy, visit HL7: http://www.hl7.org/implement/standards/product_brief.cfm?product_id=329
How can I validate my HL7 v.2.5.1 messages?
The National Institute of Standards and Technology (NIST) has released an HL7 v2.5.1 validation tool that laboratories can use to validate ELR test messages against Meaningful Use 2014 Edition Certification standards. The NIST Validation Tool website also provides access to valuable documentation about the HL7 v.2.5.1 Implementation Guide: ELR to Public Health and the vocabulary used in the profile.

The ELR TA Team has developed a presentation that provides more information on how to use the NIST tool

How can my laboratory assess our informatics capabilities?
As part of the Laboratory Efficiencies Initiative (LEI), APHL and CDC have introduced the LEI Informatics Self-Assessment (SA) Tool. The tool is the first initiative that has sought to measure overall informatics capabilities in PHLs. The tool gives PHL professionals the ability to identify and plan for their required informatics capabilities, prioritize the use of existing resources, document and communicate these priorities to policy makers and monitor current informatics capabilities on an on-going basis. To access the self-assessment tool, visit LEI Informatics.
Where can my laboratory go for more help?
APHL Informatics has partnered with CDC to offer technical assistance to PHLs and PHAs through the Electronic Laboratory Reporting Technical Assistance (ELR TA ) Project and the Public Health Laboratory Interoperability Project (PHLIP). For more information on these initiatives, visit Data Exchange Initiatives. APHL Informatics is also excited to offer Technical Assistance Consulting to PHLs. For more information on the services offered, visit Informatics Consulting Services.
What other informatics resources are out there?
APHL Informatics has collected a list of Informatics Resources for PHLs.
I need access to the internal APHL SharePoint site.
APHL Informatics maintains an internal SharePoint site collection with resources for participating PHLIP laboratories, the Change Control Board, and members of various work groups, Including the ELR TA Core Work Group and the Vocab Harmonization Work Group. If someone at your laboratory needs access to an area in this site collection, email informatics@aphl.org, or submit a request directly through the APHL SharePoint site.
How does my laboratory register a new OID?
Many HL7 implementation guides rely on object Identifiers, or OIDs, to identify different objects. For example, the PHLIP ELSM uses OIDs to specify organization, application and facility of the participating PHLIP laboratory. HL7 maintains an online OID registry; the main page of the registry lists multiple useful resources related to OIDs. HL7 also has developed an OIDs best practice document: To request an OID for your organization through CDC, email PHINMS Support. Please include the following information with each request:
  1. A high level description of your project.
  2. Is the OID request for a messaging purpose and will PHINMS be used?
  3. Will the OID be used to identify a specific application of some type?
  4. Contact information, including name of facility; contact person’s name, email, and phone #; application associated with OID

Questions to consider if you are experiencing connectivity issues

If your connection is LIMS to PHINMS or Interface Engine (e.g., Rhapsody, Mirth, other Data Broker)

Are your HL7 messages delivered as text files to a network share folder that your PHINMS then polls?
  • Are your login credentials up to date for login to the shared folder?

  • Is your polling process running

Are your HL7 messages delivered as text files to a network share folder that your Engine then polls for recent files?
  • Does your file consist of individual messages, or is it a batch file that needs to be separated?

  • If a batch file, how do you de-batch? Has anything changed in the batch formatting from the LIMS that could be causing an issue?

  • Is your polling process running

Are your HL7 messages delivered via TCP/IP socket interface over a defined port?
  • Is the port active? Does it need to be stopped and started (recycled)

  • Can you set up notifications when port communication has stopped for X amount of time?

Are your HL7 messages delivered to an engine via a FTP or sFTP query?
  • Are your credentials up to date?

  • Is your query process running

  • Have you tried stopping and restarting this process

Are your HL7 messages delivered to an engine via some kind of secure Web Service?
  • Are your certification and credentials up to date?

  • Has the sending system changed anything without notifying you?

If your connection is to PHINMS AIMS Hub

  • Once set up, the connection with AIMS is usually stable, however occsaionally the PHINMS on the Sender(CLient) side needs to be restarted, or at least the PHINMS process restarted.

If your connection is to PHINMS to CDC PHINMS

  • Is your CDC Security certificate up to date? This is the most common connectivity issue with CDC PHINMS.

If you’re still experiencing connectivity issues after reviewing the steps in this section, please contact us using our Informatics Assistance Request Form. If your laboratory is a direct sender (i.e., you are not using the hub), contact PHINMS support at PHINTech@cdc.gov.

​For more information contact, Michelle Meigs Manager, Informatics Program, 240.485.2771, michelle.meigs@aphl.org