APHL partners with state and federal government agencies, system developers, public and private sector laboratories, and others to develop laboratory informatics standards and systems.
Because electronic exchange of laboratory data involves many parties, collaboration is critical. Health partners and system developers must work closely to set data standards, identify software and hardware systems, and integrate technology platforms.
APHL, AFDO, AAFCO & FDA
The Food and Drug Administration (FDA) is partnering with the Association of Public Health Laboratories, the Association of American Feed Control Officials (AAFCO), and the Association of Food and Drug Officials (AFDO) to help build an integrated laboratory system to advance the safety of food and animal feed.
In support of this effort, APHL Informatics has developed a
discovery report on data exchange among food and feed-testing laboratories and FDA’s Electronic Laboratory Exchange Network (eLEXNET), formed a National User Group to advise FDA on data exchange mechanisms and produce a
brochure detailing the work of the National User Group and summarizing the Informatics objectives of the Cooperative Agreement between APHL, AFDO, AAFCO, and FDA. For more information on this agreement, visit
Associations’ Cooperative Agreement with FDA.
Electronic Laboratory Reporting (ELR) Task Force
The Electronic Laboratory Reporting (ELR) Task Force is a collaborative effort between the Centers for Disease Control and Prevention (CDC), the Council of State and Territorial Epidemiologists (CSTE) and APHL to promote the implementation of ELR. It is the Task Force’s vision that all laboratories, both public and private, be able to format and transmit results for reportable conditions to the responsible jurisdiction(s) using the appropriate messaging standards. The Task Force’s five high-level priorities include:
- Development of a strategic plan for coordination between states, CDC and the Office of the National Coordinator for Health Information Technology (ONC).
- Development, evaluation and endorsement of standards to reduce variation in what is required for ELR across the nation.
- Collaboration with APHL to compare and assure that PHLIP messages (formats, vocabulary and transmission) and NEDSS messages are consistent and compatible to leverage the laboratory message infrastructure to communicate with clinicians, CDC or state/local surveillance systems
- Documentation of legal considerations for electronic laboratory reporting and making available for other states to consider.
- Articulation of the resources needed to implement state/local ELR through a needs/capacity assessment.
Health Level 7 (HL7) is an internationally recognized authority on electronic message standards for health data. Many public health laboratories, public health agencies and their messaging partners exchange electronic data using HL7 standards. HL7 is a community-driven organization with workgroups comprised of HL7 members. These workgroups are collectively working towards the interoperability of health information technology.
The APHL Informatics department is actively involved in these workgroups and in the development of HL7 standards.
Integrating Healthcare Enterprise (IHE)
Integrating Healthcare Enterprise is committed to changing the way healthcare connects by improving the exchange of information among healthcare systems. IHE organizes an annual, multi-day Connectathon during which thousands of interoperability tests involving hundreds of medical information systems are conducted. APHL Informatics participates in the IHE Connectathon and in the IHE Laboratory Committee.
Laboratory Messaging Communit of Practice (LM CoP)
The LM CoP
brings together PHIN stakeholders nationwide involved in defining, implementing, maintaining, evaluating, and evolving lab messaging.
Logical Observation Identifiers Names and Codes (LOINC)
Logical Observation Identifiers Names and Codes (LOINC) is a universal coding system developing by the Regenstrief Institute for identifying laboratory and clinical observations. This system enables the exchange of electronic health data across systems.
APHL is actively involved with the LOINC community and participates in clinical and laboratory workgroups.
The Nationwide Health Information Network (NHIN)
The Nationwide Health Information Network (NHIN), a program under ONC, provides a set of standards, services and policies that are helping to build a secure, nationwide health information infrastructure to connect health providers, consumers and others supporting health and healthcare. The Network aims to:
- Give consumers more control of their health information
- Provide better information for clinical decision making
- Promote appropriate use of healthcare information beyond direct patient care
APHL is partnering with ONC to ensure that public health is recognized as a critical component of the NHIN.
National eHealth Collaborative (NeHC)
The National eHealth Collaborative (NeHC) was established by a grant from ONC to build on the accomplishments of the American Health Information Community (AHIC). NeHC brings together stakeholders from the public and private healthcare sectors who are committed to advancing health and improving healthcare by enabling secure and interoperable nationwide health information exchange. NeHC is dedicated to supporting the Nationwide Health Information Network, and NeHC provides the healthcare community with educational resources through the NeHC University.
This online collaboration tool brings together geographically dispersed professionals interested in specific informatics topics, including Electronic Laboratory Reporting (ELR), Meaningful Use, Public Health Case Reporting, Vocabulary and Messaging, and many others. A number of workgroups use phConnect communities as a communications platform.
Public Health Data Standards Consortium (PHDSC)
Members of the Public Health Data Standards Consortium (PHDSC) represent federal, state and local health agencies, academic institutions and private sector organizations. The goal of PHDSC is to provide healthcare and public health communities with health information technology standards to improve individual and community health.
APHL is involved in PHDSC’s standards development and harmonization activities, including the development of Clinical Document Architecture (CDA) templates.
Public Health Informatics Institute (PHII)
The Public Health Informatics Institute (PHII), a program of the Task Force for Global Health, is dedicated to improving health outcomes worldwide by transforming health practitioners’ ability to apply information effectively. PHII’s work focuses on requirements development, training and convening and facilitating meetings between public health professionals and their stakeholders.
Standards & Interoperability (S&I) Framework
Launched by ONC, the Standards & Interoperability (S&I) Framework is a collaborative community of participants from the public and private sectors who are focused on providing the tools, services and guidance to facilitate the functional exchange of health information. This community is dedicated to enabling harmonized interoperability specifications to support national health outcomes and healthcare priorities.
APHL participates in a number of S&I forums, and is collaborating with the CDC and ONC on S&I Framework’s Public Health Reporting Initiative (PHRI). Goals of this initiative are:
- Address the challenge of electronic data exchange between (a) between clinical care providers and public health, and (b) among public health agencies,
- Support harmonization of Public Health Reporting, Laboratory Results Interface (LRI) and the Transitions of Care (TOC) Initiatives under the ONC S&I Framework and
- Create a roadmap for harmonization of HIT standards between clinical care and population health systems beyond the Meaningful Use Stage 1 objectives.
The S&I Framework is also developing several ELR Implementation Guides for use in specific domains. The IGs include:
The Lab Results Interface (LRI) IG to report lab results to providers’ Electronic Health Record System (EHR-S). The LRI IG for ambulatory realm lab results was named in MU Stage 2.
The Lab Orders Interface (LOI) IG to send lab orders from providers EHR-S to laboratories LIS. The LOI IG begins with the ambulatory realm – and is named in voluntary MU 2015 certification and expected for MU stage 3.
The Electronic Directory Of Service (eDOS) IG to send a laboratory’s test catalog to providers’ EHR-S. The eDOS IG is expected to be named for MU stage 3.
The Electronic Health Record –System (EHR-S) Functional Requirements IG to define the functional requirements for the participating systems in laboratory-related transactions. The EHR-S Function Requirements IG begins with result incorporation into EHR-S and is expected to be named for MU stage 3.
Other joint initiatives include the creation of a LOINC order code list of the most commonly used LOINC order codes in ambulatory care setting and in Public Health related testing.
APHL Informatics Communities
In addition to these national initiatives, APHL organizes a number of community groups, including LIMS user groups, vocabulary harmonization workgroups and an Electronic Laboratory Reporting support group.