Objective: Implement ELR to reduce the number of person-hours required to enter and process paper lab reports

1. HIV/AIDS Supplemental Grant
Results Dissemination
The contents of this presentation are solely the responsibility of the authors and do not necessarily represent the
officialview sof the sponsoring or associated organizations.

2. Grant Objective and Activities
• Implement Harris
Health ELR
project
Obj1: Implement ELR to
reduce the number of
person-hours required to
enter and process paper lab
reports
Status: Met
Team Members: Kellie, Biru, Katherine,
Cepeda, Will, Kavitha, Daniel, and Harris
Health Hospital System Partners

3. HIV-ELR Grant Objective
• To implement electronic laboratory
reporting to reduce the number of person-
hours required to enter and process
paper-based laboratory reports during the
funding period.
• To monitor and maintain ELR project
activities during the funding period.

4. ELR - Background
Objective:
– to configure the city Laboratory Information System to
send positive lab results of all notifiable conditions to
the Maven (Houston’s Disease Surveillance System)
via secure electronic transmission, replacing the
conventional paper method of reporting.
2011 ELR project
• Complete creation of a Manual of Procedures
• Jamie and Norma

5. Benefits
1) Meet public health reporting guidelines
2) Centralize reporting to one data repository
3) Transmit data rapidly and consistently
4) Increase timeliness of reporting
5) Reduce person-hours & duplicate entries
6) Reduce human error
7) Increase data security

6. Procedures
• The positive reportable lab results were provided
by the City Lab in the HL7 Version 2.2 for ELR
through the output Interface into the Rhapsody
• Rhapsody securely changes the local test codes
to industry standard LOINC and SNOMED
codes and converts the message into the HL7
XML format; pushes the refined message into a
folder for Maven
• Maven picks messages from the file every hour
and creates cases in Maven which is ready for
investigation and follow up.

7. Lessons Learned from Harris
Health System
• Creation of the specimen source table
• Proper fields are populated in MAVEN
• Codes are matched accordingly
(LOINC/SNOMED)
• Mapping Table
• Continual Communication

8. Communication
• Harris Health System – COH – ORION
– 29 Meetings
– 193 Action Items
– Webinars (as needed)
– 25 Attendees (average 10)
– Go live on December 12th
• Northwest Hospital – COH – ORION
– 11 Meetings
– 64 Action Items
– 16 Attendees (average 6)
– Go live on February 15th

9. Lessons Learned from Harris
Health System ELR Project
• Specimen source table
• Mapping table
• Standard codes are matched accordingly
• Correct fields are populated in MAVEN
• Continual Communication
• 4 rounds of testing and review
• Approval process

10. Grant Objective and Activities
• Carry out
Performance
improvement
projects
Obj7: Develop procedures
to receive and process HIV-
related electronic reports
Status: Met
Team Members: Monica, Biru, Shirley,
Marcia, Karen, Jeff

11. Case Investigation and Data
Management Procedures Manual
The Bureau of Epidemiology’s HIV Surveillance Program identified a
need to improve the HIV surveillance investigation timeliness by
reducing the length of time an HIV surveillance case moves from
receipt of the initial report to data entry into Enhanced HIV/AIDS
Reporting System (eHARS). Timely completion of case investigation
will enhance surveillance reporting, HIV prevention partner notification
and linkage to care. These efforts should reduce the investigation time
without compromising investigation quality
Main projects
– Creation of Data Management Procedures Manual
– Quality Improvement Storyboard

12. Procedures Manual
The process of writing the procedure manual
comprised the following activities:
1) Reviewed previous documentation (from
procedures written for parts of the project by staff)
2) Consulting with core management team to
compile current procedures
3) Consulting with current team members to make
sure aspects of the current procedures were still
relevant, and tailoring them accordingly for any
innovations or update

13. Procedure Manual
• Results: 115 page
document
– Case Investigation
– Pediatric Case
Investigation
– Incidence Surveillance
– Data Management