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NewSTEPs Building Blocks Guide


Jun 2, 2018

Building Blocks is an important tool for Newborn Screening

Is your laboratory considering electronic messaging for newborn screening (NBS)? The Building Blocks Guide can help you plan every step of your implementation.

Physicians and public health professionals agree that the turnaround time for newborn screening (NBS) is a critical factor to positive outcomes. The Newborn Screening Technical assistance and Evaluation Program (NewSTEPs), a program of the Association of Public Health Laboratories (APHL) in collaboration with the Colorado School of Public Health (CSPH), recognizes that Health Information Technology (HIT), and specifically electronic test orders and results (ETOR), can significantly improve turnaround times, thus increasing the opportunity for early diagnosis and treatment and avoiding potential irreversible damage for infants at risk of a disorder tested on state NBS panels. Several NBS programs have implemented, or are in the process of implementing, NBS electronic messaging using program-specific methodologies with varying levels of success. NewSTEPs, with the Virginia Division of Consolidated Laboratory Services (DCLS) and J Michael Consulting (JMC), assembled members from ten NBS programs and various national stakeholders to create Building Blocks: Newborn Screening Health IT Implementation Guide and Toolkit to offer the NBS community sensible instructions and best practices for implementing a NBS electronic data exchange.

Building Blocks is written primarily from the perspective of a NBS Laboratory that is implementing ETOR with at least one hospital. While HL7 messaging is the focus of this Guide, the majority of the advice applies to any type of data exchange implementation. Building Blocks offers guidance on all phases of the project, including the technical aspects of setting up the data exchange and defining a message profile, as well as managing relationships with stakeholders and budgeting resources and time for the implementation.

“Building Blocks is a tool that will prove to be incredibly valuable to any newborn screening program at any phase of the electronic data exchange implementation process. To this point, programs have worked disparately to implement electronic data exchange, and as a result have reinvented the proverbial wheel. As the product of a collaboration between several NBS programs and national partners, Building Blocks synergistically provides guidance, uniformity, clarity, and a level of standardization to a complex process,” explains NewSTEPs Informatics Specialist, Joshua Miller.

The detailed content of Building Blocks speaks to all those involved in a NBS messaging project—laboratory professionals, project managers, hospital administration, subject matter experts, nurse managers, and other project stakeholders. Users are encouraged to approach the Guide in an à la carte fashion; the Subject Matter Expert (SME) Matrix in the appendix provides a quick means of navigating to the content most relevant for each reader.

Importantly, the Building Blocks toolkit provides resources and templates to assist in the implementation process. The toolkit includes project management templates; examples of partnership agreements; and tools worksheets to help map, implement, and validate the HL7 message. Of particular interest to terminologists and HL7 SMEs are the workbooks that the laboratory can use to complete the gap analysis between the laboratory’s systems and the message format, map local to standard codes, and validate test message.

Building Blocks also provides a real world perspective on ETOR implementation by providing relevant case studies. Many members of the NBS community contributed real-life stories that illustrate the topics addressed in the guide. These case studies instruct and inspire as they share lessons learned with other NBS programs around the country.

It is the hope of the Building Blocks team that this Guide proves useful for public health laboratories and their partners that are considering or are in the process of implementing NBS messaging. As laboratories begin to review and use the Guide, they will likely identify topics that are not covered or that would benefit from a more in depth treatment. The Health Information Technology (HIT) industry will likely continue to develop and publish tools that the NBS community will find of value. NewSTEPs and its partners therefore consider Building Blocks a living document and designed the Guide with the hope that the NBS community will continue to expand and add to it over time.

This article appeared in the Spring Issue of APHL Lab Matters. Check out the entire publication here:

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