In 2013, the Utah Department of Health (UDOH) began working with hospital and reference laboratories to implement electronic laboratory reporting (ELR) of reportable communicable disease data. Laboratories utilize HL7 message structure and standard terminologies such as LOINC and SNOMED to send data to UDOH. These messages must be evaluated for validity, translated, and entered into Utah’s communicable disease surveillance system (UT-NEDSS), where they can be accessed by local and state investigators and epidemiologists.

The Influenza Division (ID) in the Centers for Disease Control and Prevention (CDC) maintains the WHO/NREVSS surveillance system, a network of laboratories in the U.S. that report influenza testing results. This system has seen many changes during the past 40 years, especially since the 2009 H1N1 pandemic. This was due in large part to increased adoption of HL7 messaging via PHLIP. PHLIP data is detailed, standardized influenza testing information, reported in near real-time.

Domains go through phases of existence, and the electronic disease surveillance domain is no different. This domain has gone from an experimental phase, where initial prototyping and research tried to define what was possible, to a utility phase where the focus was on determining what tools and data were solving problems for users, to an integration phase where disparate systems that solve individual problems are tied together to solve larger, more complex problems or solve existing problems more efficiently.