HIMSS Latino Community | August 30, 2012 PHLIP & RnR Hub
Collaborative project to assist public health laboratories (PHLs) exchange laboratory data with the CDC and other partner agencies via electronic HL7 messaging.
The Plan • PHLIP • PHINMS Foundation • RnR Hub • Influenza Surveillance • Pandemic InfluenzaRnR In Action • ETOR Salmonella
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.
PHLIP VisionAchieve bi-directional laboratory data exchange • State public health labs (SPHL) with CDC labs • SPHLs with local partnersWhich 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 ]
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
Standards UsedTransport • PHINMSMessaging • ELSM – HL7 v2.3.1 ORU^R01 • ETOR – HL7 v2.6 OML^O33 and OUL^R22Vocabulary • LOINC for ordered and resulted tests • SNOMED for results • SNOMED and HL7 for specimen terms • HL7 elsewhere in the message
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.
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 exchangeInformation with all others on the RnR Hub• Centralized Support provided by the RnRHub Team
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
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 PanFlu testing
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
What’s Next?• Register all state public health labs on the RnR Hub• Continue to collaborate with Federal, State, and Local public healthdepartments 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 thatthe RnR Hub will serve as a connection to both the NwHIN and the StateHealth Information Networks• Additional Hub Services
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