Benefits and barriers to electronic laboratory results reporting for notifiable diseases: the New York City Department of Health and Mental Hygiene experience

OBJECTIVES: Despite national support for electronic laboratory reporting (ELR), the transition from paper to electronic reporting has been slow both nationally and locally. We assessed the ELR experience of New York City's surveillance programs to identify barriers to ELR implementation and generalizable lessons about automated electronic notifiable disease surveillance. METHODS: We conducted interviews with key staff of the New York City Department of Health and Mental Hygiene to evaluate ELR implementation. A review of paper and ELR disease reports enabled a comparison of the reporting systems. RESULTS: The completeness and timeliness of ELR were similar to, and sometimes better than, paper reporting for certain diseases. Incorporating electronic data into surveillance databases created new problems with data quality, shifted work demands, and required additional skills for data monitoring. ELR improved the handling of high-volume and time-sensitive diseases but did not completely automate reporting for diseases that required complicated assessments by staff. CONCLUSIONS: Although ELR streamlines data processing, electronic reporting has its own limitations. A more successful use of ELR can be achieved by understanding its strengths and limitations for different disease types.