Page 37 - Driving Public Health in the Fast Lane

In addition to data gaps, manual processes are incredibly burdensome to health departments and
health care providers. It is confusing to simply keep track of which diseases and conditions are still
using manual reporting versus electronic reporting. Additionally, the amount of paperwork that
must be processed is time-consuming and inefficient. For public health laboratories, often two
laboratory reports have to be exchanged: one to epidemiologists for public health purposes, and one
to the ordering health care provider for clinical diagnostic purposes. There is little infrastructure that
allows the bidirectional flow of test ordering or result reporting from health care providers to public
health laboratories, therefore, phone calls and faxes are heavily relied on. A focus group member
shared that the biggest bottleneck in their process is manually faxing 100-200 infectious disease
test results back to health care providers each day. This task not only ties up a highly trained public
health workforce in administrative activities, but also detracts from time that could be dedicated to
public health interventions. The pressure of this burden becomes acute during an outbreak or public
health emergency, when test volume is high and the public health workforce is stretched.

Highlights of other manual administrative burdens shared by the focus groups are listed below:

• If specimens are sent to CDC for testing, tests cannot be ordered electronically, and results
cannot be returned electronically. Any information shared back to jurisdictions are contained
in spreadsheets or individual PDF documents and have to be reformatted and manually entered
into the health department’s database.

Progress Made, but Silos Remain 37