The public availability of COVID statistics in Georgia has been stifled due to ELR issues. What is ELR?
Over the past few days, it has not been possible to get full and consistent reports on COVID in Georgia in general and Cobb County in our specific case due to issues with what the Georgia Department of Public describes as Electronic Laboratory Reporting, or ELR.
So what is the ELR system?
The Center for Disease Control and Prevention (CDC) has a set of pages describing the ELR.
A presentation page on the CDC website entitled How does ELR work? describes the system as follows:
Healthcare facilities and laboratories should notify public health agencies, such as state or local health departments, of the conditions to report. Historically, these reports have been received by mail, fax or phone calls and manually entered into electronic systems used for disease surveillance and case management. The ELR automates much of the reporting process by translating information from a laboratory system into an email message that can be automatically sent and processed by the public health agency.
Most laboratories have successfully moved from paper and fax to electronic notification to public health agencies. For hospitals and healthcare systems, this transition has successfully advocated for data interoperability. Laboratories communicate regularly with public health departments and providers in states, territories, cities and counties about technical barriers to notification.
So ELR takes data from a lab, hospital, or other source and writes it in a uniform message format that other systems can read.
The CDC then gives the following steps in the ELR process:
- When laboratory tests confirm infection with a state to report, such as measles, HIV, or rabies, patient information, collected specimens, tests, and results are captured and securely stored in a Laboratory Information Management System (LIMS). LIMS is a software system that supports key laboratory functions such as workflow, sample and result tracking, and electronic data exchange. Information can be entered manually into LIMS by laboratory personnel or, in some cases, laboratory instruments can be directly interfaced with LIMS to automatically transfer results to the system.
- The information in LIMS is used to create standardized electronic messages, such as HL7 v2.5.1 or other ELR formats, which can be processed and understood by other electronic systems. Tests and results can also be translated into standardized codes, such as External icon Names and codes of logical observation identifiers (LOINC) and External icon of Systematized Nomenclature of Clinical Medical Terms (SNOMED-CT).
- Once these email messages are created, they are sent from the lab to public health partners, such as the state health department or CDC, via secure transport mechanisms.
- The public health agency receives ELR messages and processes them in electronic systems that store information about reportable conditions. ELR data can be added to existing case reports or can be used to start a new report.
- Depending on the state, the state or local health department may contact the patient or the health system to conduct a case interview, initiate contact tracing, release medical countermeasures from the national strategic stock, or take action. ‘other public health measures.
So at some point in those stages that feed into the Georgia Department of Public Health’s daily status report (at stage 4 or earlier), there was an outage.
The Georgia Department of Health describes its ELR in an overview as follows:
The daily status report is updated Monday through Friday (except holidays) at 3 p.m. The data is transmitted to
Georgia Department of Public Health (DPH) numerous laboratories, hospitals and providers in various
Electronic Laboratory Reports (ELRs) are data files sent to the DPH that contain patient identifiers, tests
information and results. Individual “case” reports can also be submitted through DPH’s secure website.
portal, SendSS, healthcare providers and other registrants required. These reports often contain
more precise information about the patient. In either reporting scenario, the data may be incomplete.
The Courier has asked the Georgia Department of Public Health to further describe the point at which the state’s ELR data transfer failed, and will report back when there is a response.
For data on COVID in Cobb County and statewide
Cobb & Douglas Public Health manages the case rate on its home page, although it is not updated frequently.
A more frequently updated summary of COVID statistics for Cobb County is the CDC County View page for Cobb County. The numbers come from Georgia’s Department of Public Health, but are displayed in a much easier-to-read fashion than GDPH’s sprawling website. From this page you can get a week’s numbers on the number of new cases, the rate of cases per 100,000 population, hospitalizations, deaths and the percentage change from the previous 7 day period. . It also includes data on testing and vaccination rates.
Georgia’s public health department releases a daily pandemic situation report every afternoon around 3 p.m. .
It’s not the easiest system to navigate, but it’s worth spending the time learning how to use it if you want to get the latest national and local data on the state of COVID-19.
To get an overview of the pressure the pandemic has placed on hospital systems in terms of emergency room visits, hospital bed capacity and ventilator utilization, there is a report on hospital bed utilization and fans with interactive maps. The map is organized by hospital region and Cobb County is part of region N.
To obtain data on the percentage of patients in Georgia hospitals who have been admitted for COVID-19 compared to all other causes, there is a Patient Census of Georgia Medical Facilities. It also reports figures by state and by hospital region.