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A b s t r a c t Integrating data that reside in different systems remains an often laboriousprocess, requiring either manual steps or complicated programming. This paper describes a method for state-mandated reporting of childhood blood lead testing results that makes use of object linking and embedding technology and readily available software products to pull together information from different legacy systems. A terminal session emulator employs object linking and embedding automation to extract host data, and Visual Basic routines specify the user interface and database manipulation. This system has significantly increased the efficiency and accuracy with which blood lead testing reports are provided to the local state health department. The system provides a model for a relatively easy solution for laboratories and other groups that need a way to integrate standard data sets that are distributed across legacy systems. Integrating data from legacy systems remains one of the greatest challenges in health care informatics. Laborious and expensive methods are often necessary to combine information from two or more different systems. Information requirements for reporting childhood blood lead testing are a specific example of such a situation.Lead poisoning in children remains a major preventable environmental health problem in the United States. Approximately 1 million children in the United States have blood lead levels of at least 10 g/dL, a level that has been linked with cognition deficits, learning disabilities, and other neurodevelopment defects. 3 The CDC has recently issued revisions to its original 1991 guidelines for childhood lead screening. 4 The guidelines recommend that state health departments require clinical laboratories performing lead tests to report all lead test results and other important demographic information for persons on whom they perform testing. In Ohio, the Department of Health collects all laboratory blood lead, mercury, cadmium, and arsenic results from clinical laboratories performing such tests. The information that the clinical laboratory must report to the department typically resides in different systems, including the laboratory information system and the hospital information system. Performance of such tasks requires significant personnel time and is subject to human error.In this paper, we present a system that uses object linking and embedding (OLE) technologies and offthe-shelf tools to automate the search for and collection of legacy system data and transform these data into a format necessary for manipulation and placement into a PC-based database, in this case for heavy metal poisoning result reporting to governmental agencies.

Information management is crucial in pathology, and previous reports have stressed the needfor improved informatics training in pathology residency programs. We surveyed 150 US programs to assess informatics training with respect to types of training, proficiency expectations, and computing infrastructure. Seventy-two programs (48.0%) responded. Of the respondents, 67 (93%) reported offering informatics training; of these, 52 (78%) required it. Most programs integrated informatics into another rotation, usually management. In 37 programs (55%), the amount of informatics training has increased during the last 3 to 5 years. The most common instructional methods were hands-on training and self-study; 61 programs (91%) used multiple methods. In all but 2 programs, computers were designated for residents; 9 programs offered individual computers to residents. All programs provided productivity software. These data suggest progress in informatics training but that considerable room for improvement exists. Our data also document for the first time detailed computing resources available to residents.