BioSense: Developing Nearly Real-Time Laboratory Surveillance Capacities for Emergency Preparedness and Response

BioSense is a national program intended to improve the nation's capabilities for conducting real-time biosurveillance and health situational awareness through access to existing data from healthcare organizations. It is a CDC-developed and hosted web-based system accessing existing data from healthcare organizations across the country. The development of laboratory surveillance capacity is one of critical components of disease detection, monitoring, and building of real-time health situational awareness. BioSense collects laboratory orders and laboratory results from participating hospitals, health systems, and laboratories using the Public Health Information Network Messaging System (PHINMS) and HL7 standard.

BioSense has grown rapidly over the last two years including laboratories transmitting lab orders and results. To accommodate the collection of this information CDC has developed a data dictionary which describes a mapping process of HL7 elements to BioSense data elements. Laboratory data processing includes the “unpacking” of data at CDC, validation procedures, adding mapped and other ancillary data sets, storage in the data warehouse, and visualization of the information through a secure web application. This presentation describes the challenges and lessons learned while collecting this laboratory information for BioSense including overcoming differences among participating laboratories in reporting mechanisms, challenges on a development of communication channels with interested public health departments and professional organizations, problems with mapping of local messages to LOINC/SNOMED systems, a frequent absence of LOINC and SNOMED codes in local files etc.