Timeliness of Electronic and Traditional Laboratory Reporting in Southern Nevada, 1999-2012

This study compares the timeliness of Electronic Laboratory Reporting (ELR) with traditional reporting. ELR has been implemented in parts of the United States, and is perceived to be faster than traditional reporting. Faster reporting leads to faster public health response to prevent outbreaks, and to reduce the burden of infectious disease in communities. Nevada State law requires that diseases be reported within certain time frames. Timeliness of laboratory reporting at the Southern Nevada Health District (SNHD) from 1999-2012 was assessed by analyzing cases of four common diseases in this retrospective secondary analysis of extant data. The difference in timeliness regarding public health response (for public health investigation response time) and the difference in timeliness for legal state reporting requirements between ELR and traditional reporting were evaluated using independent samples t-tests. A two-way analysis of variance (ANOVA) was conducted to determine whether each disease had interactions with report type or influence on timeliness. The data contained 1,082 traditional reports and 1,343 ELR results. The diseases in this study were campylobacteriosis, giardiasis, salmonellosis, and shigellosis. Both t-tests, for public health response timeliness, and legal compliance timeliness were statistically different. However, it was determined that public health response time difference was not significant in later tests with a smaller confidence interval. There was no significant interaction between disease type and report type regarding public health response time. The result was significant regarding legal compliance time. This study showed that with both ELR and traditional reporting, it is impossible to prevent secondary infections when basing public health response on laboratory confirmation. The legal requirements time was inconclusive because the data were provide in days, rather than minutes. In addition, the ANOVA for ELR and legal time suggested batched results when using ELR. This study showed that response timeliness is too long in Southern Nevada, with ELR and traditional reporting. More studies of timeliness should be conducted in Southern Nevad