Building Blocks: Newborn Screening Health IT Implementation Guide and Toolkit


Several NBS programs have implemented, or are in the process of implementing, NBS messaging using program-specific methodologies with varying levels of success. To address the different approaches and inconsistent results of NBS messaging projects, NewSTEPs 360 partnered with the Virginia Division of Consolidated Laboratory Services (DCLS) and J Michael Consulting (JMC) to assemble a resource guide that offers the NBS community practical instructions and best practices for implementing a NBS electronic data exchange.

Building Blocks: Newborn Screening Health IT Implementation Guide and Toolkit is intended to fill a critical void in the world of newborn screening. The purpose of the Guide is to provide practical information to project teams that are instituting electronic messaging for NBS programs. The Guide uniquely addresses the diverse audiences related to initiating and sustaining this project and clearly outlines the steps needed to stand up electronic messaging with partners from start to finish. The detailed content of the Guide speaks to all those involved in this kind of project—laboratory professionals, project managers, hospital administration, subject matter professionals, nurse managers, and project stakeholders, among others.

The Guide is written primarily from the perspective of a state public health laboratory implementing electronic test orders and results (ETOR) with at least one hospital. In certain cases, it may be the NBS program that is managing the implementation. Nevertheless, throughout this document, we refer to the "laboratory" as the responsible entity for stylistic simplicity and because the laboratory will be the entity most affected by the new processes. In our hypothetical implementation, the laboratory has opted to utilize the Health Level 7 (HL7) 2.5.1 standard to accomplish this ETOR. It is assumed that the laboratory will design messages based on the HL7 Laboratory Results Interface (LRI) and Laboratory Orders  Interface (LOI) Implementation Guides developed by the Standards and Interoperability (S&I) Framework. HL7 is generally considered to be the common standard for electronic public health messaging, but the laboratory may choose an alternative form of data exchange, such as a web portal. While HL7 messaging is the focus of this Guide, the majority of the advice offered applies to any type of data exchange implementation.

To provide targeted help for a variety of disparate professionals, the Guide is designed to be modular in use. This arrangement allows project teams or individual contributors to go directly to the portions of the guide that pertain to their specific needs, regardless of their focus. In other words, users can approach the Guide in an à la carte fashion. For example, a project manager may not need to take a deep dive into the nuts and bolts of message orders, while a subject matter expert (SME) may appreciate the more granular details related to HL7 messaging. Readers can use the SME Matrix described below to navigate to the content that is most relevant to them.