2014.ISDS.Abstracts.Final.pdf


ISDS Annual Conference Proceedings 2014. This is an Open Access article distributed under the terms of the Creative Commons Attribution-
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153

ISDS 2014 Conference Abstracts

Tracking Communicable Disease Electronic Laboratory 
Data in New York State 

Candace M. Noonan-Toly*, Xiaohong Wang and Hwa-Gan Chang

Epidemiology, NYS Department of Health, Albany, NY, USA

Objective
Ensure all reportable communicable disease data coming through 

the Electronic Clinical Laboratory Reporting System (ECLRS) 
is reported to the Communicable Disease Electronic Surveillance 
System (CDESS) in a timely and complete manner.

Introduction
All positive laboratory tests of reportable conditions on persons 

residing in New York State (NYS) are mandated to be sent to the NYS 
Department of Health (NYSDOH) via ECLRS. NYS, excluding New 
York City (NYC), receives over 100,000 ECLRS messages on general 
communicable diseases (CD) and hepatitis (HEP), not including 
Lyme disease and Influenza, annually. Although ECLRS is integrated 
with CDESS, the local health departments (LHD) need to review 
each lab report for proper initiation of a case investigation. Once the 
investigation is created, the LHD may need supportive evidence to 
create a reportable case or may dismiss it if evidence does not support 
the case definition.

Our goal is to follow all ECLRS records from official retrieval 
by the LHD through CDESS case creation, to ensure all cases are 
reported and are done so in a timely manner. Cases for diseases 
that are nationally notifiable are sent to CDC the following week 
for publication in the Morbidity and Mortality Weekly Report. 
Timely reporting to CDC allows for more accurate description of 
disease occurrence, which is essential for public health planning and 
response.1

Methods
All ECLRS records transferred to CDESS by LHD staff are recorded 

in an interface table with a key that is unique to the investigation 
created on CDESS. Any ECLRS records or CDESS investigations 
that are dismissed are recorded with a reason for dismissal which 
includes: Does not meet case definition; Duplicate report; Negative; 
Out of state/NYC; Not a human report; Not a sterile site; False 
positive; Not a reportable disease; and Case already reported. Any 
reasons deemed unacceptable are followed up on with the LHD.

The LHD is given 60 days before the NYSDOH contacts them 
regarding outstanding laboratory reports. Routinely, ECLRS records 
are matched by the unique key with CDESS and any records that do 
not match are reviewed. Records are de-duplicated by patient name, 
date of birth, and disease prior to follow-up.

Timeliness is calculated as the number of days between the ECLRS 
official retrieval date and the CDESS investigation creation date and 
is used as a performance measure. Very high priority diseases must 
have an investigation created on CDESS within one day of official 
retrieval, average priority diseases three business days, low priority 
diseases five business days.

Results
From January 2012 through May 2014, ECLRS received 85,730 

CD messages. Thirty-four percent were dismissed prior to becoming 
investigations, the primary reason being duplicate report (27%), 
followed closely by negative report (26%). Sixty-six percent of the 
ECLRS CD messages were transferred to CDESS. Of the 56,395 

transferred messages, 38,236 became unique investigations. The 
percent of cases created from CD investigations increased from 
69.8% in 2012 to 76% in Jan-May 2014. Accordingly, the percent 
of dismissed investigations has decreased 30.2% in 2012 to 23.7% 
in Jan-May 2014. The majority of CD investigations were dismissed 
(>50%) because they did not meet case definition. Tickborne diseases 
accounted for 44% of CD dismissed investigations because they did 
not meet case definition.

Of the 187,560 ECLRS HEP messages received, 12.1% were 
dismissed from ECLRS, of which 55% were dismissed as a duplicate 
report. Yearly, from Jan 2012-May 2014, on average 90% of the 
unique HEP investigations became cases or updated existing cases.

A performance incentive program was conducted from November 
1, 2013 through April 30, 2014 with comparison of 2012 data for 
timeliness. The percentage of timely reports created went from 
83.3% for lowest priority diseases through 88.6% for highest priority 
diseases in 2012, to 98.5% for low priority and 100% for high priority 
in 2014.

Conclusions
Follow-up of CD messages ensures complete reporting of all 

diseases. All laboratory reports can be tracked through our systems. 
The high percentage of duplicate reports needs review as it increases 
the work of the LHDs. The performance measures reports for LHDs 
will continue as incentives for continued timeliness.

Keywords
surveillance; data; communicable; laboratory; tracking

References

[1] Adekoya N, Truman B, Davies-Cole J, Ajani U,”Comparison of 
Provisional and Finalized 2011 Data from the weekly National 
Notifiable Diseases Surveillance System of the United States”.2014.
Located at:Division of Health Informatics and Surveillance,Center for 
Surveillance,Epidemiology and Laboratory Services,Office of Public 
Health Scientific Services.

*Candace M. Noonan-Toly

E-mail: candace.noonan-toly@health.ny.gov