Florida Newborn Screening ELO / ELR Project

PHI Conference

• Janet Firestone, Data Administrator, Florida Dept of Health

• Andrew Richardson, Children’s Medical Services, Florida Dept of Health

• Eduardo Gonzalez Loumiet, Data Integration Project Manager, Florida Dept of Health

Speakers Introduction

• All babies born in the State of Florida have their heals pricked and 5 drops of blood are placed on a blood card before discharge.

• The blood card has about 50 fields on it, is hand-written, and then mailed to the Bureau of Laboratories (BOL) in Jacksonville.

• Once the card arrives at the lab, the blood spots are removed and 14 data entry operators type in all of the demographic information from the blood card.

• The blood is tested in high tech machines by chemists, and upon completion, our follow-up system sends the results back to the hospitals via an autofax solution.

• The autofax solution is at capacity, and sends approximately 60 - 70% of test results back to the hospitals.

• The test results that don't make it through the autofax solution are printed out are sent via mail to the submitting entity.

Today

Facility Name City No of Spec CardsWINNIE PALMER HOSPITAL ORLANDO 17280FLORIDA HOSPITAL ORLANDO - LAB ORLANDO 11107ST JOSEPH WOMEN HOSPITAL TAMPA 8833JACKSON MEMORIAL HOSPITAL MIAMI 7338TAMPA GENERAL HOSPITAL TAMPA 6410SOUTH MIAMI HOSPITAL SOUTH MIAMI 5925BAPTIST HOSPITAL OF MIAMI MIAMI 5566MEMORIAL HOSPITAL WEST PEMBROKE PINES 5310SACRED HEART HOSPITAL PENSACOLA 5161TALLAHASSEE MEM REG MED CTR TALLAHASSEE 4756BROWARD GENERAL MEDICAL CENTER FORT LAUDERDALE 4571

NBS Statistics

2013 Total – 265,000

Blood Card

Florida NBS ELO/ELR Project

Project Summary

• Develop and maintain a bi-directional Electronic Laboratory Ordering (ELO) and Electronic Laboratory Reporting (ELR) interface between Florida’s hospital Laboratory Information Management Systems (LIMS) and the Florida Department of Health’s Bureau of Laboratories for Newborn Screening (NBS) tests.

• The project would focus on improving the efficiency and timeliness of Newborn Screening test result reporting, not only for the BOL, but also for all Florida hospitals.

Enterprise Data IntegrationFoundations We Build on

• FDOH Data Integration Program started in 1998 as a response to requests for ELR for surveillance systems– Researched available tools– People are as important as tools – integration is a mindset as well as a

skill set. Training is mandatory– Started with a small implementation but in a framework that would scale

• Pilot project – ELR for STD’s resulted in immediate benefits and gained us support at an Enterprise level

• 15 yrs later and we are processing over – 4 million lab results for surveillance– 40 million Immunization transactions– $200 million in HIPAA Compliant Claims for medical services– 300 files not requiring transformation– Our 1st year of processing over 1 million lab orders/requests– And now our latest project Newborn Screening, which leverages knowledge gained over the

last 15 years.

Foundation: Infrastructure

Integration Transport

FileMover

Foundation: Tool Belt

Foundation: Standards

PHLIP RnR• All Children's• Labcorp• Mayo

Direct Send• 25 US states• CDC• Quest• SNTC• BBRHIO• Specialty Labs• Cerner• Finlay• Halifax• Sarasota• Clinlab

• Hundreds of trading partnersSFTP

• IRL• Palm Beach County

• Pilot testing

ELR

ELR DB

Merlin (DSS)

• SQL• Surveillance• Palm Beach

IIS

HMS ELOELR

HMS (Cache)

67 County HDs

Data Integration Team

• NBS

PRISM STD

Foundation: Data Integration

• Billing • 2013 – Claims: 1,532,572

Charges: $143,167,363

• FileMover • 1,464 routes• 5,289 sources and destinations• 2013 – 1,752,631 files moved

• SFTP • 1,800 accounts

Foundation: Data Integration

• ELR• 2013 – Results received 4,872,523 • HL7 2.5.1 (ELC HITECH)

• Florida SHOTS

• 2013 – Files: 2738411 Shots: 13,459,073

• Influenza results to the CDC• 2013 – 4,444

• PHIN Certification• Varicella, Tuberculosis

Foundation: Experience• ELR in production in 1999• Public Health Laboratory Interoperability Project (PHLIP)• Electronic Laboratory Surveillance Message (ELSM) – influenza results to

the CDC• Electronic Test Order/Result (ETOR) Salmonella – salmonella orders to the

CDC • ELC HITECH Project – HL7 2.5.1 between SPHL LIMS, providers, SPHA,

and the CDC.• PHLIP RnR Hub - development and management• Laboratory Information Management System Interoperability (LIMSi) project• A strong working relationship with the Newborn Screening area in the

Children’s Medical Services program• Pandemic Influenza Project between Florida, Texas, Virginia, and the CDC

Standards

Registration Form

Addendum

• Planning meetings between Florida’s Bureau of Labs, Data Integration Team, Division of Information Technology, and Newborn Screening Program.

• Discovery meetings with: PerkinElmer, Cerner, Baptist Health, and Winnie Palmer.

• Electronic surveys have been sent to dozens of Florida hospitals with a significant response rate of interest in participating in the Florida-NBS-ELO/ELR Project.

• Partnership with Cerner.

• The Data Integration Team has begun development of the Mirth channels in preparation for initial testing.

• Reviewed the US National Library of Medicine Newborn Screening Coding and Terminology Guide and mapped it to the Florida Blood Card.

• Delivered the mapping documentation to Cerner and Adventist.

Project Status

Partnership

Collaboration

• Robin Lusk• Jodi Vaughn• Lois Taylor• Dr Ming Chan• John Butler• Susanne Crowe

• Tom Dates• Pam Tempson• Jasmin Torres• Bonifacio Dye• Keith James• Josh Hayes