LA County Dept. of Public Health Pathology Data to Public Health - Intro Raymond Aller, M.D. Director, Automated Disease Surveillance Los Angeles County Department of Public Health 10 September 2007

LA County Dept. of Public Health 10 September The diversity of public health ….  Improving the public’s health, in a variety of ways  Takes the population point of view, rather than the individual patient  Ascertain – act - assure

LA County Dept. of Public Health 10 September The diversity of pathology  Surgical pathology – individual diagnoses via personal service  Clinical pathology – assuring usefulness of a variety of diagnostic and monitoring assays  Forensic pathology – why and how did they die?

LA County Dept. of Public Health 10 September For each subspecialty, a different way we can support public health …  Surgical pathology –Tumor diagnoses –Other findings of PH importance –Research findings: asbestos  Clinical pathology ** –Infectious diseases, toxic exposures, etc –Population patterns – antimicrobial susceptibilities, rate of test orders  Forensic pathology –Infectious diseases, toxins, etc. –Injury and violence prevention data

LA County Dept. of Public Health 10 September Electronic Lab Reporting (ELR)  Software on the laboratory information system automatically selects from all laboratory results, those which are reportable to public health  In other cases, ALL results transferred to a filtering system, that selects reportables  These may be enhanced by other findings of public health importance –Antimicrobial susceptibility testing –Syndromic indications  ELR commonly doubles the reporting rate

LA County Dept. of Public Health 10 September Benefits of fully automated Electronic Lab Reporting  More rapid transmittal of required reports  More complete reporting  Savings in lab staff time  More accurate transmission  Assured HIPAA compliance

LA County Dept. of Public Health 10 September Two different categories of data Public Health Disease Surveillance Identified disease cases Findings in large populations Case reports from Infection control practitioners, nurses physicians, others Diagnostic laboratory findings ELR vCMR Antimicrobial results Emergency department chief complaints Over the counter medications RODS Syndromic ELR Lab orders ELR

LA County Dept. of Public Health 10 September Data Transformation Hospital Systems Public Health Information System Public Health Information System Public Health Information System Web page Data entry Format converter De-identification (of “non-reportable” findings) Collation Text handling Routing PH compliant HL7 messages PH compliant HL7 messages PH compliant HL7 messages These functions may be performed in the Public Health Department, Data Producing Facility or an Intermediary Filter Code translation Code translations

LA County Dept. of Public Health 10 September How do I get my lab connected?  Talk with your local PH department –Are they ready to receive data? –What format/coding do they want?  Talk with the vendor of your lab’s Lab Information System –How to install their PH interface module? –Does it match the specs of your local PH? –Modules/capability available from Misys, Meditech, Cerner, SCC, Orchard, others soon

LA County Dept. of Public Health 10 September How else can we help PH?  We have a valuable skill set –Much pathology training also prepares one for PH –Not necessary to have specialized PH training to make a valuable contribution to PH

LA County Dept. of Public Health 10 September How can we contribute?  On contract or salary –PH laboratory director –Communicable disease (infection control) –Informatics –As Health Officer  As a volunteer –Especially in third world context

LA County Dept. of Public Health 10 September Questions? Follow up? Raymond D. Aller, M.D I look forward to hearing from you.