Mary Kate Yost-Daljev
Mar 19, 2026
The Results Are In: What Public Health Labs Need Most from Data Modernization — And How JMC Is Helping
In the Spring 2026 issue of APHL Lab Matters, an article titled “The Results Are In: Data Modernization at Public Health Laboratories Is a Work in Progress”—written by Melanie Kourbage, Lead Specialist in Informatics—highlighted the current landscape of data modernization (DMI) efforts across public health laboratories (PHLs). The piece summarizes a national APHL survey of Chief Informatics Officers, Interoperability Coordinators, and Informatics Program Managers regarding their progress, challenges, and priorities in modernizing laboratory data systems.
The survey revealed four top priority areas for laboratories:
Instrument Interfacing
Data Exchange and Data Sharing
System Replacements
System Assessments
These themes align closely with the work JMC has been leading in public health informatics. Below is a deeper look at each priority area—and how JMC’s experience is helping laboratories modernize successfully.
1. Instrument Interfacing: Simplifying a Complex Challenge
Instrument interfacing in public health laboratories is notoriously complex. PHLs operate a wide variety of instruments across disciplines—from analytical chemistry to molecular diagnostics—often supplied by different vendors and accompanied by different software and data formats. Meanwhile, a single laboratory information management system (LIMS) oftentimes must maintain bi-directional communication with instruments, reliably delivering worklists, and ingesting and interpreting results and process data.
JMC has tackled this challenge with a flexible, practical approach:
Multiple Interfacing Paths
We have supported:
Simple file-based integrations, including validated Excel transfers.
Complex bidirectional interfaces, using standard instrument communication languages like ASTM 1381/1394
Third-party brokers, such as Rhapsody, which allow data translation and routing between instruments and the LIMS. See more about our work interfacing instruments with Rhapsody!
All these approaches require Custom transformations, translating raw instrument output into standardized formats that the LIMS can easily consume.
Understanding the Data Behind the Instrument
Successful interfacing requires more than moving data from Point A to Point B. Public health labs depend on:
Internal controls
Quality control metrics
Calibration data
Comparative data across instruments
JMC works closely with lab staff to understand which data elements matter and how they should be represented so they support quality management and downstream analyses. This deep data understanding is essential—not only for workflow efficiency, but also for comparing results across instruments and preserving overall laboratory quality.
2. Data Exchange and Data Sharing: Strengthening Public Health Infrastructure
Data exchange was the second-highest modernization priority in the APHL survey, and it is foundational to public health practice. PHLs provide the data that, among others:
Initiates infectious disease investigations
Supports outbreak detection
Feeds reportable disease surveillance systems
Enables newborn screening follow-up
JMC has extensive experience supporting all of these data flows.
Building and Implementing Standards
JMC team members have participated in national workgroups, including APHL, ASTP/ONC, and HL7, contributing to the development of:
HL7 v2 messaging guides
FHIR exchange standards
Standardized vocabularies for reportable disease data
We’ve implemented exchanges for:
ETOR (Electronic Test Orders and Results)
ECR (Electronic Case Reporting)
ELR (Electronic Laboratory Reporting)
Nationally Notifiable Disease Case Notifications
Immunizations
ETOR: A High Value Upgrade
ETOR benefits laboratories by:
Reducing manual order entry
Lowering error rates
Improving turnaround time
Ensuring higher integrity of laboratory data
Providers and senders benefit as well—they
receive results in a structured, standardized format rather than relying on paper, PDFs, or manual transcription. Take a look at the work JMC has done with ETOR implementation!
Supporting RCKMS and National Systems Like It
Our extensive work with the Reportable Conditions Knowledge Management System (RCKMS) has significantly strengthened J Michael Consulting’s (JMC) expertise in national‑scale public health informatics and electronic case reporting (eCR). RCKMS, developed by the Council of State and Territorial Epidemiologists (CSTE) in partnership with CDC and APHL, serves as an authoritative, real‑time portal that centralizes public health reporting requirements and supports automated decision‑making for determining whether a case is reportable and to which jurisdiction(s). This system plays a critical role in improving the accuracy, timeliness, and completeness of public health reporting across the United States, addressing long‑standing challenges such as inconsistent criteria across jurisdictions and the difficulty reporters face in locating up‑to‑date requirements. [cste.org][rckms.org]
Through our involvement, JMC has deepened its expertise in standardized coding, laboratory result mapping, and the complex process of identifying conditions that meet jurisdiction‑specific reporting rules. These capabilities are essential for supporting eCR workflows, which rely on machine‑processable rules authored and maintained in RCKMS. The JMC RCKMS Content team uses epidemiologic expertise and internationally recognized resources to develop the reporting criteria that allow jurisdictions to tailor eCR to their specific needs. These rules are operationalized by value sets using standardized code systems like LOINC, SNOMED CT, and ICD10CM, that the team creates and maintains in the NLM VSAC tool. The platform’s authoring interface allows jurisdictions to create, modify, and deploy reporting criteria—capabilities that directly support automated processing of electronic initial case reports (eICRs) to determine reportability status. [cste.org].
Our work has given JMC a unique and practical understanding of how laboratory and healthcare data must be structured and encoded to align with the national standards underpinning reportable conditions. This includes experience with the RCKMS Knowledge Repository and Decision Support Service (DSS), which runs jurisdictional rules against EHR‑generated data to determine whether a potential case is reportable and, if so, where it must be sent. [rckms.org]
The importance of RCKMS to public health cannot be overstated. It provides a single authoritative portal for reporting specifications and reduces the burden on clinicians, and health systems by consolidating what was previously highly fragmented, jurisdiction‑specific, human‑readable information into a machine‑processable format. This centralization improves interoperability, strengthens disease surveillance, and enhances the efficiency with which public health agencies can manage and update reporting requirements as conditions evolve—an especially critical capability highlighted during rapidly emerging threats such as COVID‑19, when RCKMS was able to quickly add new reporting rules to support national response efforts. [rckms.aims...atform.org][hln.com]
By supporting jurisdictions’ adoption and refinement of RCKMS content, JMC directly contributes to a modernized national reporting infrastructure that ensures accurate, timely, and automated case detection—a cornerstone of effective public health response.
3. System Replacements and 4. System Assessments: Ensuring Laboratories Choose the Right Path
Many PHLs continue to rely on aging or endoflife systems which fail to mee the needs of their current workflows. As a result, system assessments and replacements have become urgent priorities.
JMC’s standardized approach—EASI (Evaluate, Assess, Select, Implement)—helps laboratories understand the true state of their current systems and determine the best path forward.
What EASI Provides
A clear map of the current-state environment
Identification of gaps in workflows, technology, and data
Recommendations on whether to:
Move to RFP for a new system
Optimize or enhance the current system
Because JMC has deep experience with multiple LIMS platforms and vendors, we can support laboratories through every phase of the process—from assessment to selection to implementation.
Why This Matters
A system replacement is one of the largest investments a public health laboratory makes. With EASI:
Labs gain confidence that a new system truly meets their needs.
Standardized processes are identified and reinforced.
Pain points in the current system are clearly understood and addressed.
This structured, informed approach ensures that modernization is not only successful, but sustainable.
Learn more about EASI at our upcoming APHL Innovate Session at the APHL annual conference!
Conclusion
The APHL survey confirms what many already know: data modernization in public health laboratories is essential, complex, and still very much underway. From instrument interfacing to standards-based data exchange to system assessments and replacements, laboratories are navigating multiple transformation efforts at once.
JMC’s breadth of expertise—spanning standards development, LIMS optimization, instrument integration, and large-scale system implementations—positions us to be a strong partner in this national modernization effort. As laboratories continue to advance their DMI initiatives, JMC remains committed to supporting them with the technical, operational, and strategic guidance needed to build a more modern and resilient public health data ecosystem.