title: Improvements in timeliness resulting from implementation of electronic laboratory reporting and an electronic disease surveillance system.
abstract: OBJECTIVE
  Electronic laboratory reporting (ELR) reduces the time between communicable disease diagnosis and case reporting to local health departments (LHDs). However, it also imposes burdens on public health agencies, such as increases in the number of unique and duplicate case reports. We assessed how ELR affects the timeliness and accuracy of case report processing within public health agencies.
  
  
  METHODS
  Using data from May-August 2010 and January-March 2012, we assessed timeliness by calculating the time between receiving a case at the LHD and reporting the case to the state (first stage of reporting) and between submitting the report to the state and submitting it to the Centers for Disease Control and Prevention (second stage of reporting). We assessed accuracy by calculating the proportion of cases returned to the LHD for changes or additional information. We compared timeliness and accuracy for ELR and non-ELR cases.
  
  
  RESULTS
  ELR was associated with decreases in case processing time (median = 40 days for ELR cases vs. 52 days for non-ELR cases in 2010; median = 20 days for ELR cases vs. 25 days for non-ELR cases in 2012; both p<0.001). ELR also allowed time to reduce the backlog of unreported cases. Finally, ELR was associated with higher case reporting accuracy (in 2010, 2% of ELR case reports vs. 8% of non-ELR case reports were returned; in 2012, 2% of ELR case reports vs. 6% of non-ELR case reports were returned; both p<0.001).
  
  
  CONCLUSIONS
  The overall impact of increased ELR is more efficient case processing at both local and state levels.
authors.affiliation: The University of North Carolina at Chapel Hill, Gillings School of Global Public Health, North Carolina Institute for Public Health, Chapel Hill, NC ; Current affiliation: Durham County Department of Public Health, Durham, NC.
authors.forename: Erika
authors.initials: E
authors.lastname: Samoff
authors.forename: Mary T
authors.initials: MT
authors.lastname: Fangman
authors.forename: Aaron T
authors.initials: AT
authors.lastname: Fleischauer
authors.forename: Anna E
authors.initials: AE
authors.lastname: Waller
authors.forename: Pia D M
authors.initials: PD
authors.lastname: Macdonald
mesh_terms: D002984:Clinical Laboratory Information Systems / Q000458:organization & administration* / Q000592:standards; D003140:Communicable Disease Control / Q000458:organization & administration; D018563:Disease Notification / Q000379:methods* / Q000592:standards; D006801:Humans; D009111:Local Government; D009657:North Carolina / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods*; D013219:State Government; D013997:Time Factors