1. 1 Interoperability with Web Services Environmental Health Labs Leverage Existing Technology to Collect Sample Data Presenter: Lynda Vidot NCEH National Centers for Environmental Health NCPHI National Centers for Public Health Informatics

2. 2 Each year, the Centers for Disease Control and Prevention (CDC) and Public Health Partners conduct many studies where millions of samples are collected and shipped to the CDC for testing. How do you keep track?

3. 3 Many initiatives are currently underway for the consistent and real time exchange of sample, shipment and lab results data Public Health Laboratory Interoperability ProjectPublic Health Laboratory Interoperability Project HL7 MessagingHL7 Messaging Communities of PracticeCommunities of Practice What happens in the interim?

4. 4 The Plan NCEH and NCPHI have collaborated to leverage the benefits of technologies that are compatible with LIMS and familiar to users Spreadsheets Web services

5. 5 The Pilot A study out west where approximately 300 samples of urine and water were collected for testingA study out west where approximately 300 samples of urine and water were collected for testing During the study, sample data was loaded into a predefined spreadsheet structure using approved vocabulary and pre- printed sample labelsDuring the study, sample data was loaded into a predefined spreadsheet structure using approved vocabulary and pre- printed sample labels At the conclusion of sample collection and preparationAt the conclusion of sample collection and preparation –Samples were shipped to NCEH –The spreadsheet was uploaded into LUNA and –Sample data was immediately available at the NCEH for viewing and downloading via LUNA and the NCEH LIMS (LSTARS)

6. 6 This figure illustrates the top level STARRS components and mechanisms of interaction with STARRS Client Use LUNA to Exchange information & Meet PHIN objectives

7. 7 Use LUNA to manage specimen identification All specimens entered into LUNA are uniquely identified by numbers linked together at the CDC. The IDs can originate from various sources. LUNA uses them to accurately and specifically identify each specimen. LUNA can collect and link: All State or Local specimen IDsAll State or Local specimen IDs All internal CDC specimen IDsAll internal CDC specimen IDs One pair of CDC enterprise-standard IDsOne pair of CDC enterprise-standard IDs

8. 8 Use LUNA to track specimen shipments Where is the shipment I sent, and what is its status? User creates a shipment record with a CDC tracking ID (CTID) User sends the shipment to the CDC CDC labs verify receipt of the shipment User checks on the status of the shipment

9. 9 Use LUNA to get results LUNA allows the CDC to disseminate results to targeted users electronically Results available quickly and specificallyResults available quickly and specifically All results entered by CDC internal labsAll results entered by CDC internal labs are available ONLY to authorized partners

10. 10 LUNA supports PHIN initiatives LUNA is designed to work for you now and into the future. The system supports a number of specified PHIN initiatives: Preparedness effortsPreparedness efforts Migration to HL7 messagingMigration to HL7 messaging Registration in the PHIN directoryRegistration in the PHIN directory Connecting Lab systemsConnecting Lab systems Vocabulary standardsVocabulary standards

11. 11 LUNA supports migration to HL7 Messaging Data objects convert to HL7 segmentsData objects convert to HL7 segments Working to create an HL7 shipment message and/or segment Working to create an HL7 shipment message and/or segment HL7 Segment Segment name PID Patient ID SPMSpecimen ORC Test Order OBR Test Request OBX Test Result LUNA Data Objects Test Subject Specimen Test Order Test Request Test Result

12. 12 LUNA supports vocabulary standards LUNA uses HL7HL7 SNOMEDSNOMED LOINCLOINC Local registered value setsLocal registered value sets Field in LUNA Code System Version Abnormal Flags HL7 - 0078 2.5 Observation Results status HL7 - 0085 2.5 Observation Value SNOMEDn/a Universal service ID LOINCn/a Specimen Condition HL7 - 0493 2.5 Specimen Handling Code HL7 – 0376 2.5 Specimen Type HL7 – 0487 2.5 Examples…

13. 13 LUNA supports registration in the PHIN directory Integration with PHIN Directory: Prevents delay in shipments due to incorrect or outdated contact informationPrevents delay in shipments due to incorrect or outdated contact information Allows user information updates and additions in a single locationAllows user information updates and additions in a single location Saves time spent maintaining identical user information in multiple placesSaves time spent maintaining identical user information in multiple places

14. 14 LUNA connects lab systems

15. 15 STARRS connects lab systems

16. 16 STARRS connects lab systems This figure illustrates the top level STARRS components and mechanisms of interaction with STARRS Client

17. 17 LUNA and You How can we refine, improve, and better meet your needs with LUNA? You’re Invited to… View LUNA DemoView LUNA Demo Ask questionsAsk questions Contribute in User groupsContribute in User groups Contribute in Focus groupsContribute in Focus groups

18. 18 For more information on STARRS or LUNA, please contact us: EMAIL: starrs@cdc.gov starrs@cdc.gov EMAIL: luna@cdc.gov For more information about the NCEH study, please contact: Dr. Robert Jones EMAIL: rlj0@cdc.gov rlj0@cdc.gov Thank you! The findings and conclusions in this presentation are those of the author and do not necessarily represent the views of the Centers for Disease Control and Prevention.