Design and Implementation of Data Exchange Formats for Molecular Detection of Drug-Resistant Tuberculosis

Abstract

Drug-resistant tuberculosis (TB) remains a public health threat to the United States and worldwide control of TB. Rapid and reliable drug susceptibility testing (DST) is essential for aiding clinicians in selecting an optimal treatment regimen for TB patients and to prevent ongoing transmission. Growth-based DST results for culture-confirmed cases are routinely reported to the U.S. Centers for Disease Control and Prevention through the National TB Surveillance System (NTSS). However, the NTSS currently lacks the capacity and functionality to accept laboratory results from advanced molecular methods that detect mutations associated with drug resistance. The objective of this study is to design and implement novel comprehensive data exchange formats that utilize the Health Level Seven (HL7) version 2.5.1 messaging hierarchy to capture, store, and monitor molecular DST data, thereby, improving the quality of data, specifications and exchange formats within the NTSS as well as ensuring full reporting of drug-resistant TB.

Figure 1.

Supported segments between the HL7 v2.3.1 ELR message and the HL7 v2.5.1 ELR message.

Figure 2.

DTBE ORUˆR01 Message Hierarchy with key RVCT 2020 Data Elements.