1. PHLIP RnR Hub for ELSM
& Beyond
ELSM October 25, 2010

2. •RNR Hub
•ELSM
•Pandemic Influenza
•Electronic Lab Reporting
The Plan

3. Florida RnR Hub Team
•Frans de Wet
•John Butler
•Jeff Couch
•Eddie Gonzalez Loumiet
Uber Operations
contractors to:
•Florida Dept of Health
•Texas Dept of State Health
Services
•Assoc of Public Health Labs

4. Public Health Laboratory
Interoperability Project
(PHLIP)
PHIN-MS Route-Not-Read Hub
(RnR Hub)

5. • 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 NHIN 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.
What is PHLIP?

6. Achieve bi-directional laboratory data exchange
•State public health labs (SPHL) with CDC labs
•SPHLs with local partners
Which will
•Improve data quality and accessibility
•Improve data sources for active surveillance
•Develop and test future system approaches
•Create a Strengthened collaborative environment for public health
National Interoperable Laboratory System
PHLIP Vision

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

8. • 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)
• 7-year old product deemed “mission critical” by CDC
• Over 700 PHIN-MS nodes used in U.S.
What is PHINMS?

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

10. RnR Hub
Solution

11. •The RnR Hub focuses on reducing the overhead of the PHIN-MS Direct Send
model
•A PHIN-MS receiver is not required for bi-directional messaging
•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
What is the RnR Hub?

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

13. 18 Labs In Production

14. State Public Health Labs
Maine
Maryland
Minnesota
Missouri
Nebraska
New Mexico
Colorado
Florida
Hawaii
Indiana
Iowa
Alabama
Alaska
Arizona
Arkansas
California
Rhode Island
South Carolina
Texas
Utah
West Virginia
Wisconsin
Participants

15. 2. Pandemic Influenza Project
3. Electronic Lab Reporting in Florida
& Beyond

17. •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
Pan Flu Project: Goals

20. DISTANCE from
Tallahassee to
AUSTIN = 868 MILES

22. • Chapter 64D-3 of the Florida Administrative Code
• Notifiable diseases and conditions
• Disease surveillance
• HL7
Electronic Lab Reporting

23. Data Transmission:
• sFTP
• PHIN-MS
• VPN
• Dedicated Circuit
Electronic Lab Reporting

25. • 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
• Begin work on additional use cases like Salmonella and the ETOR
• Continue development of the PHLIP architecture, with the
expectation that the RnR Hub will serve as a connection to both the
NHIN and the State Health Information Networks.
What’s Next?

26. Reusable Components

27. Teamwork

28. http://bit.ly/PHLIP-Info http://bit.ly/PHLIP-FLASH
http://bit.ly/RNR-1 http://bit.ly/RNR-2http://bit.ly/PHINMS
Additional Resources

29. Eduardo “Eddie” Gonzalez Loumiet
Team Leader – FL RnR Hub
Uber Operations, LLC
eddie@uberops.com
(850) 766 – 5338
Michelle M. Meigs
Manager, Informatics Program
Association of Public Health Laboratories
8515 Georgia Ave. Suite 700
Silver Spring, MD 20910
michelle.meigs@aphl.org
508-494-5958 (mobile)
240-485-2771
Contact Information