HIMSS Latino Community presentation on PHLIP and RnR Hub

1. HIMSS Latino Community | August 30, 2012
PHLIP & RnR Hub

2. Collaborative project to assist public health laboratories (PHLs)
exchange laboratory data with the CDC and other partner
agencies via electronic HL7 messaging.

3. The Plan
• PHLIP
• PHINMS
Foundation • RnR Hub
• Influenza Surveillance
• Pandemic Influenza
RnR In Action • ETOR Salmonella

4. What is PHLIP?
• A National Resource: Information and laboratory scientists at the state and
federal level addressing highly complex technical issues critical to public health.
• A Collaboration: commitment to utilize NwHIN IT architecture options for the
exchange of electronic laboratory data at all levels of public health laboratories.
• A Community: to support and expand LIMS user communities, creating a
process that can be applied to other highly complex problems.
• Products and Publications: Documentation of decisions made, fiscal and
human resources needed, and lessons learned. Development and dissemination
of Vocabulary and Messaging guides to meet the needs of the Public Health
Laboratory “harmonized” list of LOINC and SNOMED codes for nationally
notifiable diseases (NND’s).
• A Success: The realization of common goals and national priorities in a
production environment.

6. Fax/Web Surveillance

7. PHLIP Vision
Achieve bi-directional laboratory data exchange
• State public health labs (SPHL) with CDC labs
• SPHLs with local partners
Which will
• Improve data quality, accuracy and accessibility
• Improve and expand data sources for active surveillance
• Create a strengthened collaborative environment for public health
National Public Health Laboratory System
[ Integrated and Interoperable ]

8. PHLIP Building Blocks
• National collaborative process
• Provide detailed vocabulary
implementation guidelines
• Build PHL capability for electronic test
ordering and result reporting
• Develop and pilot data exchange
architecture options
• Establish a process to help labs increase PHLIP Florida RnR Hub Team
messaging capability

9. Standards Used
Transport
• PHINMS
Messaging
• ELSM – HL7 v2.3.1 ORU^R01
• ETOR – HL7 v2.6 OML^O33 and
OUL^R22
Vocabulary
• LOINC for ordered and resulted tests
• SNOMED for results
• SNOMED and HL7 for specimen
terms
• HL7 elsewhere in the message

10. What is PHINMS?
• Public Health Information Network – Messaging System
• Provides public health applications a common platform for message
transport
• Secure and reliable over the Internet
• Standards-based -“De-facto” standard for secure message transport
• Available at no cost to users
• Applications using PHINMS include: BioSense, ELR, LRN,
NBS,NND, NHSN, LabCorp, PerSe, Foodborne, BSIO, PHLIP
• Used by Public Health Information Network Certification (PHIN)
• 10-year old product deemed “mission critical” by CDC
• Over 700 PHIN-MS nodes used in U.S.

11. What is PHINMS?

12. Direct Send Model
Multiple Senders to Multiple Receivers = exponential growth of
connections and maintenance

13. Solution
RnR Hub

14. What is the RnR Hub?
• The RnR Hub focuses on reducing the overhead of the PHINMS Direct
Send model
• Additional firewall configuration is not typically required for each Trading
Partner – infrastructure needs are low
• Facilitates rapid implementation of electronic message exchange
• Low deployment costs for partners - Ability to send pre-configured install
“package”
• Reduction of management burden
• Message routing
• Certificate management
• Hardware and bandwidth needs
• Once on the RnR Hub, you can exchange
Information with all others on the RnR Hub
• Centralized Support provided by the RnR
Hub Team

15. RnR Hub in Action
1. ELSM – Surveillance Message
2. Pandemic Influenza
3. ETOR Salmonella

16. PHLIP Use Case 1 – ELSM
Influenza – Electronic Laboratory Surveillance Message
• Goal: All states sending
Influenza results via the PHLIP PHLIP Route-
HL7 Message to CDC Not-Read
Hub
• New states to complete
HL7 Test Result HL7 Test Result
readiness assessment and
agree to PHLIP decisions
• All states to provide Influenza State Public CDC –
reporting metrics Health Lab Influenza
(SPHL) Division
• PHLIP Assistance Teams to
deliver onsite and virtual
support and PHLIP Program
Management to provide Message Format: HL7 2.3.1 ORU
oversight.
Contents: Influenza Laboratory Results (WHO Global Influenza
Surveillance Network)
• Future: additional PHLIS agents
as prioritized by CDC

18. Influenza

19. RnR Hub in Action
1. ELSM– Surveillance Message
2. Pandemic Influenza
3. ETOR Salmonella

21. Pan Flu Project: Goals
•Exchange of influenza lab data with:
•Local partners
•Other states
•Federal partners
•International partners
•Exchange of lab test orders and results
•Develop surge capacity model for Pan
Flu testing

22. DISTANCE from
Tallahassee to
AUSTIN = 868 MILES

24. RnR Hub in Action
1. ELSM– Surveillance Message
2. Pandemic Influenza
3. ETOR Salmonella

25. Use Case 2 – ETOR Service Requests
State to CDC – Electronic Test Order and Result
• HL7 Test Order from State
Public Health Lab (PHL) to PHLIP
CDC Lab(s) Route-Not-
Read Hub
• HL7 Test Result from CDC HL7 Test Order HL7 Test Order
Lab(s) to State PHL
HL7 Test Result HL7 Test Result
• Limited Scope Production State
CDC Labs
phase includes Salmonella Public
Salmonella
and Bacillus anthracis Health Lab
& BRRAT
(SPHL)
Message Format:
• Order = HL7 2.6 ORM
• Result = HL7 2.6 OUL
Contents: Salmonella & Bacillus Anthracis Orders and Results
Status: In progress

26. What’s Next?
• Register all state public health labs on the RnR Hub
• Continue to collaborate with Federal, State, and Local public health
departments in addition to private health care providers and labs
• Continue to work on additional use cases like Electronic Lab Reporting
(ELR) in support of Meaningful Use
• Expand to other diseases for state to CDC and state to state
• Continue developing interoperability between Direct, SFTP and PHINMS
• Continue development of the PHLIP architecture, with the expectation that
the RnR Hub will serve as a connection to both the NwHIN and the State
Health Information Networks
• Additional Hub Services

27. Collaboration

28. Contact Information
Eduardo Gonzalez Loumiet, MBA, PMP, CPHIMS
Uber Operations, LLC
Contractors to the Association of Public Health Labs
eduardo@UberOps.com
(850) 766-5338
www.APHL.org | www.UberOps.com