1. The Analyses of Statewide Laboratory Surveys for Electronic Laboratory Reporting
Hwa-Gan Chang1
Dave DiCesare1
Kathryn Schmit1
Jennifer Baumgartner2
Laura Goodman2
Charles DiDonato3
Perry Smith1
1 New York State Department of Health
2 New York City Department of Health
3 Keane, Inc

2. New York ECLRS Development and Implementation
Initiation Development Implementation Maintenance/ Mandatory
Enhancement
current
ECLRS RFP
& a Vendor
Selected
ECLRS Development
ECLRS Training
1st Lab Roll out
Add HIV, Lead
NYCDOH, Cancer
Report card Audit
Law passed
Add Cong Malf,
Newborn

3. Electronic Clinical Laboratory Reporting System (ECLRS)
Health Commerce Network
State Program Areas
Clinical Labs
HL-7/ASCII/Web entry
Cancer
Congenital
Malformation
ECLRS
HIV
Hospital
Emergency
Departments
Lead
Internet
Internet
Emergency
Department
Public
Health Lab
Perinatal
Hep B
General
Communicable
STD TB
Local Health Departments/ NYCDOH

4. New York Mandatory Electronic Laboratory Reporting
Law was passed on July 18, 2007 and was posted on ECLRS home page
A letter was mailed to laboratory directors (N=927) in February
A lab survey was developed and posted on ECLRS web page in March 2008
A reminder was ed to lab contacts in May 2008

5. Lab survey #2: Paper survey filled out by DOH investigators
Materials
Lab survey #1: Web survey entered by laboratory staff
Lab survey #2: Paper survey filled out by DOH investigators

6. Lab Survey #1- Objectives
To gain knowledge regarding type of tests that labs perform
To identify labs that are not reporting via ECLRS
To learn which LIS vendors are used
To learn which reference labs are used

8. Survey Questions
Lab location and contact information
Testing of specimens from NYS residents (Y/N)
Types of tests performed for:
General Communicable Diseases (68)
Sexually Transmitted Diseases (6)
Tuberculosis
HIV
Heavy metals (lead, arsenic, cadmium, mercury, zinc)
Pathology/Cancer
Congenital Malformations
Hemoglobin A1c

9. Survey Questions Reference labs used
Laboratory Information System vendors
Program area specific information
NYCDOH: susceptibility testing, Hemoglobin A1c
HIV: type of testing, kit
Cancer: facilities served
Heavy Metals: type of Metals
Congenital Malformations: type of cytogenetic testing

10. Labs Responded to Survey (N=440), Response Rate =43%
Labs Test NY Residents (N=391)
Types of Labs
Location of Labs

11. Labs Testing NYS Residents
213 labs: General Communicable Diseases
Less than 10 diseases tested for:
10 – 30 diseases tested for: 71
31 – 60 diseases tested for: 83
202 labs: Sexually Transmitted Diseases
100 labs: Tuberculosis
46 labs: HIV
54 labs: Heavy metals
24 labs: Congenital Malformations
161 labs: Pathology / Cancer

12. Use of Reference Labs Yes: 159 hospital labs, 83 commercial labs
No: hospital labs, 118 commercial labs
Most frequently used reference labs:
QUEST
NYSDOH public health lab
LABCORP
MAYO
SPECIALTY
NYCDOHMH LAB
ARUP

13. Lab Information System Vendors
Hospital labs: 190
MEDITECH 47
SOFT
CERNER
MYSIS 23
SUNQUEST 18
IN-HOUSE 6
Other
Commercial labs: 201
MEDITECH
SOFT
CERNER
MYSIS
SUNQUEST
IN-HOUSE
Other

14. Number of Labs Reporting via ECLRS by Reportable Conditions
Labs that responded
Labs that report to ECLRS
General Communicable STDs, TB
224
195
19 in progress
HIV 46
Cancer
161 36
4 in progress
Heavy Metals 54 48
Congenital Malformations 24 1
2 in progress
Labs that do not report to ECLRS 10 1 2 21

15. Lab Audit Survey #2- Objectives
To validate lab contact information while visiting labs for audit
To randomly select 8 general communicable, STD, and 8 HIV tests from lab log for validation
To evaluate labs’ completeness of reports if reporting via ECLRS

16. Survey Questions
Lab contact information
Surveyor information
Type of tests certified by State
Name, location, and test type of reference labs
A representative sample of 8 positive test results by test type with specimen accession number, collection date, and reportable condition

17. Lab Survey Results for Communicable Diseases as of July 31, 2008
No. of Laboratories Surveyed
N=380
No. of Labs Reporting via ECLRS
N=251
No. of Labs Not Reporting via ECLRS
N=129
100% Reporting
N=150
Partial Reporting
N=11
List not matched
N=14
Enrolled / Just certified
N=76
Do not test for reportable diseases
N=125
Test for reportable diseases
N=4

18. Summary Form builder utility can be easily applied to any web survey
The low lab web survey response rate indicated the difficulty of obtaining information, but the responses were helpful in identifying labs not reporting via ECLRS
The investigators visiting labs were valuable for evaluating the completeness of reports via ECLRS
For communicable disease lab reporting, virtually 98% labs are reporting electronically