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LA County Dept. of Public HealthLA County Dept. of Public Health
Pathology Data to Public Health - Intro
Raymond Aller, M.D.Director, Automated Disease Surveillance
Los Angeles County Department of Public Health
10 September 2007
LA County Dept. of Public HealthLA County Dept. of Public Health10 September 2007 2
The diversity of public The diversity of public health ….health ….
Improving the public’s health, in a variety of ways
Takes the population point of view, rather than the individual patient
Ascertain – act - assure
LA County Dept. of Public HealthLA County Dept. of Public Health10 September 2007 3
The diversity of pathology The diversity of pathology
Surgical pathology – individual diagnoses via personal service
Clinical pathology – assuring usefulness of a variety of diagnostic and monitoring assays
Forensic pathology – why and how did they die?
LA County Dept. of Public HealthLA County Dept. of Public Health10 September 2007 4
For each subspecialty, a For each subspecialty, a different way we can different way we can support public health …support public health …
Surgical pathology– Tumor diagnoses– Other findings of PH importance– Research findings: asbestos
Clinical pathology **– Infectious diseases, toxic exposures, etc– Population patterns – antimicrobial susceptibilities,
rate of test orders Forensic pathology
– Infectious diseases, toxins, etc.– Injury and violence prevention data
LA County Dept. of Public HealthLA County Dept. of Public Health10 September 2007 5
Electronic Lab Electronic Lab Reporting (ELR)Reporting (ELR)
Software on the laboratory information system automatically selects from all laboratory results, those which are reportable to public health
In other cases, ALL results transferred to a filtering system, that selects reportables
These may be enhanced by other findings of public health importance– Antimicrobial susceptibility testing– Syndromic indications
ELR commonly doubles the reporting rate
LA County Dept. of Public HealthLA County Dept. of Public Health10 September 2007 6
Benefits of fully automated Benefits of fully automated Electronic Lab Reporting Electronic Lab Reporting
More rapid transmittal of required reports
More complete reportingSavings in lab staff timeMore accurate transmissionAssured HIPAA compliance
LA County Dept. of Public HealthLA County Dept. of Public Health10 September 2007 7
Two different categories of dataTwo different categories of data
PublicHealth
Disease Surveillance
Identified diseasecases
Findings in large populations
Case reports fromInfection control
practitioners, nursesphysicians, others
Diagnostic laboratory findings
ELR
vCMR
Antimicrobialresults
Emergency department chief complaints
Over the counter medications
RODS
Syndrom
ic
ELR
Lab ordersELR
LA County Dept. of Public HealthLA County Dept. of Public Health10 September 2007 8
Data Transformation Data Transformation
HospitalSystems
Public Health
Information System
Public Health
Information System
Public Health
Information System
Web page Data entry
Format converter
De-identification
(of “n
on
-rep
orta
ble
” find
ing
s)
Collation
Text handling
Routing
PH compliantHL7 messages
PH compliantHL7 messages
PH compliantHL7 messages
These functions may be performed in the Public Health Department, Data Producing Facility or an Intermediary
Filter
Code translationCode translationCode translations
LA County Dept. of Public HealthLA County Dept. of Public Health10 September 2007 9
How do I get my lab How do I get my lab connected?connected?
Talk with your local PH department – Are they ready to receive data?– What format/coding do they want?
Talk with the vendor of your lab’s Lab Information System– How to install their PH interface module?– Does it match the specs of your local PH?– Modules/capability available from Misys,
Meditech, Cerner, SCC, Orchard, others soon
LA County Dept. of Public HealthLA County Dept. of Public Health10 September 2007 10
How else can we help PH?How else can we help PH?
We have a valuable skill set– Much pathology training also prepares
one for PH– Not necessary to have specialized PH
training to make a valuable contribution to PH
LA County Dept. of Public HealthLA County Dept. of Public Health10 September 2007 11
How can we contribute?How can we contribute?
On contract or salary– PH laboratory director– Communicable disease (infection control)– Informatics– As Health Officer
As a volunteer– Especially in third world context
LA County Dept. of Public HealthLA County Dept. of Public Health10 September 2007 12
Questions? Follow up?Questions? Follow up?
Raymond D. Aller, M.D.
213-989-7208
I look forward to hearing from you.
