1. Florida Newborn Screening
ELO / ELR Project
PHI Conference

2. • Janet Firestone, Data Administrator, Florida Dept of Health
• Andrew Richardson, Children’s Medical Services, Florida Dept of Health
• Eduardo Gonzalez Loumiet, Data Integration Project Manager, Florida Dept
of Health
Speakers Introduction

3. • All babies born in the State of Florida have their heals pricked and 5 drops of
blood are placed on a blood card before discharge.
• The blood card has about 50 fields on it, is hand-written, and then mailed to
the Bureau of Laboratories (BOL) in Jacksonville.
• Once the card arrives at the lab, the blood spots are removed and 14 data
entry operators type in all of the demographic information from the blood card.
• The blood is tested in high tech machines by chemists, and upon completion,
our follow-up system sends the results back to the hospitals via an autofax
solution.
• The autofax solution is at capacity, and sends approximately 60 - 70% of test
results back to the hospitals.
• The test results that don't make it through the autofax solution are printed out
are sent via mail to the submitting entity.
Today

4. Facility Name City No of Spec Cards
WINNIE PALMER HOSPITAL ORLANDO 17280
FLORIDA HOSPITAL ORLANDO - LAB ORLANDO 11107
ST JOSEPH WOMEN HOSPITAL TAMPA 8833
JACKSON MEMORIAL HOSPITAL MIAMI 7338
TAMPA GENERAL HOSPITAL TAMPA 6410
SOUTH MIAMI HOSPITAL SOUTH MIAMI 5925
BAPTIST HOSPITAL OF MIAMI MIAMI 5566
MEMORIAL HOSPITAL WEST PEMBROKE PINES 5310
SACRED HEART HOSPITAL PENSACOLA 5161
TALLAHASSEE MEM REG MED CTR TALLAHASSEE 4756
BROWARD GENERAL MEDICAL CENTER FORT LAUDERDALE 4571
NBS Statistics
2013 Total – 265,000

5. Blood Card

6. Florida NBS ELO/ELR Project
Project Summary
• Develop and maintain a bi-directional Electronic Laboratory
Ordering (ELO) and Electronic Laboratory Reporting (ELR)
interface between Florida’s hospital Laboratory Information
Management Systems (LIMS) and the Florida Department of
Health’s Bureau of Laboratories for Newborn Screening (NBS)
tests.
• The project would focus on improving the efficiency and
timeliness of Newborn Screening test result reporting, not
only for the BOL, but also for all Florida hospitals.

7. Enterprise Data Integration
Foundations We Build on
• FDOH Data Integration Program started in 1998 as a
response to requests for ELR for surveillance systems
– Researched available tools
– People are as important as tools – integration is a mindset as
well as a skill set. Training is mandatory
– Started with a small implementation but in a framework that
would scale
• Pilot project – ELR for STD’s resulted in immediate benefits and gained
us support at an Enterprise level
• 15 yrs later and we are processing over
– 4 million lab results for surveillance
– 40 million Immunization transactions
– $200 million in HIPAA Compliant Claims for medical services
– 300 files not requiring transformation
– Our 1st year of processing over 1 million lab orders/requests
– And now our latest project Newborn Screening, which leverages knowledge
gained over the last 15 years.

8. Foundation: Infrastructure

9. Integration Transport
FileMover
Foundation: Tool Belt

10. Foundation: Standards

11. PHLIP RnR
• All Children's
• Labcorp
• Mayo
Direct Send
• 25 US states
• CDC
• Quest
• SNTC
• BBRHIO
• Specialty Labs
• Cerner
• Finlay
• Halifax
• Sarasota
• Clinlab
• Hundreds of trading partners
SFTP
• IRL
• Palm Beach County
• Pilot testing
ELR
ELR DB
Merlin (DSS)
• SQL
• Surveillance
• Palm Beach
IIS
HMS ELO
ELR
HMS (Cache)
67 County HDs
Data Integration Team
• NBS
PRISM
STD

12. Foundation: Data Integration
• Billing
• 2013 – Claims: 1,532,572
Charges: $143,167,363
• FileMover
• 1,464 routes
• 5,289 sources and destinations
• 2013 – 1,752,631 files moved
• SFTP
• 1,800 accounts

13. Foundation: Data Integration
• ELR
• 2013 – Results received 4,872,523
• HL7 2.5.1 (ELC HITECH)
• Florida SHOTS
• 2013 – Files: 2738411 Shots: 13,459,073
• Influenza results to the CDC
• 2013 – 4,444
• PHIN Certification
• Varicella, Tuberculosis

14. Foundation: Experience
• ELR in production in 1999
• Public Health Laboratory Interoperability Project (PHLIP)
• Electronic Laboratory Surveillance Message (ELSM) – influenza results to
the CDC
• Electronic Test Order/Result (ETOR) Salmonella – salmonella orders to the
CDC
• ELC HITECH Project – HL7 2.5.1 between SPHL LIMS, providers, SPHA,
and the CDC.
• PHLIP RnR Hub - development and management
• Laboratory Information Management System Interoperability (LIMSi) project
• A strong working relationship with the Newborn Screening area in the
Children’s Medical Services program
• Pandemic Influenza Project between Florida, Texas, Virginia, and the CDC

15. Standards

16. Registration Form

17. Addendum

18. • Planning meetings between Florida’s Bureau of Labs, Data Integration Team, Division of
Information Technology, and Newborn Screening Program.
• Discovery meetings with: PerkinElmer, Cerner, Baptist Health, and Winnie Palmer.
• Electronic surveys have been sent to dozens of Florida hospitals with a significant
response rate of interest in participating in the Florida-NBS-ELO/ELR Project.
• Partnership with Cerner.
• The Data Integration Team has begun development of the Mirth channels in preparation
for initial testing.
• Reviewed the US National Library of Medicine Newborn Screening Coding and
Terminology Guide and mapped it to the Florida Blood Card.
• Delivered the mapping documentation to Cerner and Adventist.
Project Status

19. Partnership

20. Collaboration
• Robin Lusk
• Jodi Vaughn
• Lois Taylor
• Dr Ming Chan
• John Butler
• Susanne Crowe
• Tom Dates
• Pam Tempson
• Jasmin Torres
• Bonifacio Dye
• Keith James
• Josh Hayes