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INTRODUCTION

All laboratories have established processes for sample submission; these processes are 

designed based on their day-to-day, routine submission volume. However, during outbreak 

situations, these established processes may not be appropriate for the increased volume of 

samples and demands of ongoing response activities. 

In particular, the processing and messaging of large volumes of laboratory results into the 

Emergency Management Response System 2.0 (EMRS2)— the USDA APHIS Veterinary 

Services (VS) system of record in any foreign animal disease (FAD) outbreak— is problematic 

for any National Animal Health Laboratory Network (NAHLN) laboratory (and other laboratories)

that have not prepared and tested these processes. Without electronic messaging processes, 

results are not automatically matched to the corresponding investigation and premises, which 

leads to significant backlogs and can delay appropriate response actions. Thirteen NAHLN 

laboratories electronically messaged avian influenza diagnostic results during the 2014–2015 

highly pathogenic avian influenza outbreak. Currently, there are 47 laboratories that are 

approved to message avian influenza results, which demonstrates important progress. While 

significant improvements have been made, particularly for high-volume laboratories in 

livestock/poultry dense States, most NAHLN laboratories do not currently message all

laboratory results for all FADs.

Choosing to implement any of the following recommendations will enhance the efficiency of 

sample submission and information management processes; however, their effects are 

synergistic, so opting for all four recommendations will provide the best outcome. Whereas the 

implementation of these recommendations necessitates changes in both processes and culture, 

the benefits of maximizing automated processes include decreasing the need for additional 

resources and minimizing errors.

RECOMMENDATION 1: MESSAGE ALL RESULTS FOR ALL FOREIGN ANIMAL 

DISEASES FROM NAHLN LABS.

Benefits

Messaging allows the real-time transfer of large volumes of results without any additional data 

entry. Subsequently, laboratories are free to concentrate on testing rather than answering 

questions about specific results. By eliminating the need for extra data entry, the information is 

not only more accurate, it is rapidly available and enables automatic notifications on positive 

results for immediate action.

EMRS 2.0

Recommended Sample Submission 

Processes in Outbreaks

June 15, 2020

The messaging of results, associated transfer, and subsequent matching of large 

volumes of accurate results to investigations and premises in EMRS2 is critical 

for detection of new disease cases, surveillance activities, and continuity 

of business operations.
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Challenges

Messaging requires the lab to have a Laboratory Information Management System (LIMS) that 

is capable of messaging. In addition, staff will require some Information Technology (IT) 

expertise, and the lab will need to bear the associated cost of both the system and the 

appropriate personnel/expertise to set up. 

RECOMMENDATION 2: USE PRE-PRINTED LAB SUBMISSION FORMS WITH 

BARCODED PREMISES ID, AND VALIDATED ADDRESS AND FARM NAMES FOR 

ALL COMMERCIAL SURVEILLANCE AND RETURN BACKYARD PREMISES 

VISITS.

Benefits

Pre-printed lab submission forms eliminate the confusion of which samples are associated with 

which premises. This allows for the messaging of lab results and automatic linkage of the

results with the investigation that has been entered into EMRS2. The alternative, sifting through 

spreadsheets with hundreds or thousands of laboratory results and trying to match them to the 

correct premises, is extremely time consuming and neither an efficient or effective way of doing 

business. Pre-printed forms can be formatted and produced as PDF for any premises in 

EMRS2, then distributed to companies for ease of circulation to their producers. Sample types, 

reasons, and other information can be pre-printed on the form and further reduce data entry 

requirements, while improving data accuracy.

Challenges

Laboratories typically have their own forms which they prefer to use for lab submissions. In 

addition, companies must be willing to not only distribute the forms, but ensure their producers 

are trained in using the forms. If a premises does not have a National Premises Identification 

Number (PIN), then it cannot make use of pre-printed forms until the PIN has been assigned 

and obtained.

RECOMMENDATION 3: USE PRE-PRINTED PAIRED BARCODE STICKERS: ONE 

FOR THE SAMPLE CONTAINER, AND ONE FOR THE LAB SUBMISSION FORM ON 

THE LINE FOR THE MATCHING SAMPLE.

Benefits

Use of barcode stickers has been demonstrated to ensure and facilitate the accurate entry of 

sample identification and automated matching of the sample/premises to the associated result 

in EMRS2. For commercial premises and return backyard visits, barcodes are scanned when 

the sample arrives at the laboratory and provides a consistent, legible method of sample 

identification so results are associated with the correct premises. Barcode stickers are an 

inexpensive, standard inventory control tool that eliminates another opportunity for human error 

in a fast-paced, rapidly changing outbreak situation.

Challenges

In order make the most impact in a large outbreak, barcoding must be implemented (i.e., 

barcodes provided) in advance of the outbreak so samples are immediately matched to their 

submission form/premises. Barcodes must be widely distributed to producers; there are four
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identical barcodes in a set. One barcode sticker goes on the sample, one on the NVSL Lab 

submission for (VS 10-4, one on the State Lab Submission form, and one is extra. Labs also 

apply their own internal barcodes for sample tracking and are sometimes resistant to adding a 

barcode for other uses. 

RECOMMENDATION 4: USE EMRS2GO MOBILE APPLICATION OFFLINE FOR 

ALL BACKYARD SURVEILLANCE.

Benefits

Using EMRS2GO eliminates the need for additional data entry for backyard surveillance. It 

provides the ability to show progression of backyard surveillance, including premises without 

livestock/poultry, in nearly real-time. Tablets and laptops can be used offline and synced with 

EMRS2 when an internet connection is available. Near the end of the day, applicable labs can 

be notified of the volume of samples to expect based on the data in the EMRS2GO system. 

EMRS2GO has been demonstrated to save hundreds of labor hours by preventing the need for 

additional data entry and avoiding transcription errors from paper records.

Challenges

EMRS2GO must be downloaded and installed on tablets or laptops, which requires IT support. 

Initial training is typically required prior to use. EMRS2GO is not available for smartphones.