Government leadership in addressing public health priorities: strides and delays in electronic laboratory reporting in the United States

Abstract

For nearly a decade, interest groups, from politicians to economists to physicians, have touted digitization of the nation's health information. One frequently mentioned benefit is the transmission of information electronically from laboratories to public health personnel, allowing them to rapidly analyze and act on these data. Switching from paper to electronic laboratory reports (ELRs) was thought to solve many public health surveillance issues, including workload, accuracy, and timeliness. However, barriers remain for both laboratories and public health agencies to realize the full benefits of ELRs. The New York City experience highlights several successes and challenges of electronic reporting and is supported by peer-reviewed literature. Lessons learned from ELR systems will benefit efforts to standardize electronic medical records reporting to health departments.

FIGURE 1—

Literature review inclusion decision tree for electronic laboratory reports in public health. Note. ELR = electronic laboratory report; LOINC = Logical Observation Identifiers Names and Codes. The term SNOMED was not included in the search criteria because it did not noticeably improve the results of the search over using the term LOINC alone.