The U.S. unincorporated territory of Guam in the Western Pacific is a tropical island approximately 3,800 miles west of Hawaii, 1,500 miles south of Japan, and 1,500 miles east of the Philippines. Guam is the largest and southernmost island of the Mariana archipelago and has been a U.S. possession since 1898, making it the westernmost possession of the United States. The closest neighboring islands to Guam are of the Commonwealth of the Northern Mariana Islands: Rota, Tinian and Saipan. Situated in the Western Pacific, across the
international dateline, Guam is the largest of more than 2,000 islands scattered between Hawaii and the Philippines. The island is surrounded by active reefs and 12 small, uninhabited limestone islands. The population is multi-ethnic, with an estimated population of 166,506 in 2023.
Guam is known as "Where America's Day Begins" because it is the westernmost U.S. territory and is positioned east of the International Date Line. This means that Guam is one day ahead of the United States mainland, experiencing the new day first. The Guam Public Health Laboratory (GPHL) handles approximately 10,000 specimens annually. It provides diagnostic testing and supports the public health surveillance teams. GPHL was largely paper-based, with disconnected workflows and slower access to critical data, during the COVID-19 pandemic. With funding from the Epidemiology and Laboratory Capacity (ELC) program, GPHL has established a partnership with the OpenELIS Foundation to address these challenges. With OpenELIS Laboratory Information Management System (LIMS) provides GPHL with an automated process, which reduces manual data entry and provides quicker, real-time consolidated access to data across multiple facilities and programs within Guam’s Department of Public Health and Social Services (DPHSS).
Implementation
The implementation process spans over couple of years to ensure thorough implementation and training:
1. Setting Up the Cloud Environment
In 2020, the GPHL and ELC staff began foundational training to prepare for the implementation of OpenELIS. At the same time, OpenELIS developers worked with InductiveHealth Informatics (IHI) and Guam’s Office of Technology (OTECH) to build an environment based on required security protocols. IHI hosts the OpenELIS system, and OTECH manages the Government of Guam’s network infrastructure.
2. Staff Training and Workflow
GPHL lab staff has completed thorough training of the system, supported by job aids, as well as assistance with updating standard operating procedures (SOP) where required.
3. Parallel Testing and Go-Live
A parallel testing period between February to June 2024 was completed, which allowed the laboratory to test workflows and ensured OpenELIS operates as expected. GPHL conducted parallel testing, running their current paper-based process alongside OpenELIS. Results were successful, and OpenELIS officially replaced the paper-based system in the middle of June 2024.
Benefits for Guam Public Health Laboratory
- Consolidation: Laboratory data is unified in one secure, cloud-based platform.
- Cost Effectiveness: Cloud-based deployment with flexible options, easily scaled as needed with lower upfront costs.
- Efficiency: Automated data entry and result reporting to other clinicians and public health programs reduces human error and speed up processes.
- Scalability: The platform’s configuration ensures it meets the unique needs of Guam’s existing systems and a future-proof solution for public health surveillance and diagnostic testing.
- Seamless Data Exchange: OpenELIS facilitates system-to-system communication, eliminating the need for manual data transfers and thus human error.
Looking Ahead
GPHL anticipates the relocation to a new and permanent facility—the Guam Public Health Training and Biosafety Level 3 Laboratory—by June 2026. As part of this move, GPHL plans to interface lab instruments with OpenELIS, which is critical for automating the reporting of test results. This interface will require interfacing and connecting laboratory instruments to the laboratory network, then installing and configuring the instrument interface for each assay.