Electronic Lab Reporting Guidelines for Medicare and Medicaid EHR Incentive Program Participants
The Texas Department of State Health Services (DSHS) manages the Texas National Electronic Disease Surveillance System (NEDSS), which accepts HL7 formatted electronic laboratory test reports indicative of notifiable conditions.
Hospitals who intend to submit electronic laboratory reports (ELR) to DSHS must register with the NEDSS office. Click here to register your hospital's intent to submit ELR.
After registering, NEDSS staff will provide information about resources hospital facilities can use to assist them to create standards-based ELR messages and so they can evaluate those messages prior to submitting test messages to DSHS. Hospital facilities are required to ensure all ELR messages are correctly formatted and content is valid before the interface may be activated for onboarding processes and live data submission. The resources below describe the ELR onboarding process and the DSHS requirements in detail.
Contact NEDSS@dshs.state.tx.us with questions or for more information about ELR reporting to public health.
Questions related to the EHR incentive payment program should be directed to the Health and Human Services Commission, the single state Medicaid agency. Please review the website information thoroughly at www.tmhp.com/pages/healthit/hit_home.aspx before contacting the support desk at HealthIT@tmhp.com.
Frequently Asked Questions Regarding Electronic Lab Result Submission in Texas:
Q: What type of lab tests results should eligible hospitals and providers submit? Can you provide us a list of the lab tests of which results we need to submit?
A: Notifiable conditions (any laboratory examination of a specimen derived from a human body which yields microscopical, cultural, serological, or other evidence of a reportable disease) should be reported according to the implementation guidelines provided above.
Q: When can I submit the lab results to the public health agency?
A: The Texas NEDSS ELR system at DSHS is currently operational.
Q: Where do I submit the lab results to?
A: The NEDSS ELR system at DSHS is the single point of contact for laboratory result reporting indicative of notifiable conditions. For assistance, please contact NEDSS@dshs.state.tx.us. The NEDSS staff will provide eligible providers and hospitals (or hospital systems) with data format specifications and will schedule technical assistance as needed.
Q: What about my facility’s test results that are performed and reported by a commercial lab? Will those count toward my MU requirements?
A: Any electronic interface intended to satisfy a meaningful use requirement to submit data to a public health agency must be a certified EHR product. Eligible providers and eligible hospitals are required to send ELR data from Certified EHR Technology to qualify for the respective EHR incentive program.
- Eligible hospitals and providers should submit positive test results for reportable conditions performed in their hospital lab from their certified EHR to DSHS. It is not a requirement to send test results of tests performed by commercial laboratories. However, when a specimen is sent to a reference lab for testing (ie, the hospital is not the performing facility but does have record of the test result in their EHR), hospitals have found great benefit and it has become best practice to include those tests in their ELR interface to public health.
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CMS EHR Incentive Payment Program Criteria: ELR
Stage 1 Menu Set Objective for Eligible Hospitals or Critical Access Hospitals (CAHs) to Submit Lab Results
ELR Reporting- Meaningful Use Requirements – Overview
Eligible providers may choose at least one of two public health objectives and measures from a menu set to meet the meaningful use requirements in Stage 1. These objectives include submitting electronic immunization information to immunization registries or immunization information systems, and/or submitting electronic syndromic surveillance data to public health agencies. Eligible hospitals must also choose at least one public health objective from the menu set which includes the two objectives previously listed and/or submitting electronic laboratory results to public health agencies.
Capability to submit electronic data on reportable (as required by State or local law) lab results to public health agencies and actual submission according to applicable law and practice.
Performed at least one test of certified EHR technology’s capacity to provide electronic submission of reportable lab results to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which an eligible hospital or CAH submits such information has the capacity to receive the information electronically).
Eligible hospitals and CAHs must attest YES to having performed at least one test of certified EHR technology’s capacity to submit electronic data on reportable lab results to public health agencies (unless none of the public health agencies to which the eligible hospital or CAH submits such information has the capacity to receive the information electronically), except where prohibited, to meet this measure.
Exclusion for Eligible Hospitals and CAHs: Exclusion in accordance with paragraph (b)(2) of this section. No public health agency to which the eligible hospital or CAH submits such information has the capacity to receive the information electronically.
- The test to meet the measure of this objective must involve the actual submission of information to public health agencies, if one exists that will accept the information. Simulated transfers of information are not acceptable to satisfy this objective.
- The transmission of actual patient information is not required for the purposes of a test. The use of test information about a fictional patient that would be identical in form to what would be sent about an actual patient would satisfy this objective.
- An unsuccessful test to submit electronic data to public health agencies will be considered valid and would satisfy this objective.
- If the test is successful, then the EP should institute regular reporting with the entity with whom the successful test was conducted, in accordance with applicable law and practice. There is not a measurement associated with this reporting.
Stage 2 Core Set Objective for Eligible Hospitals or Critical Access Hospitals (CAHs) to Submit Lab Results
ELR Reporting- Meaningful Use Requirement – Overview
To demonstrate meaningful use under Stage 2 criteria, Eligible hospitals and CAHs must meet 16 core objectives and 3 menu objectives that they select from a total list of 6, or a total of 19 core objectives. ELR reporting has moved from a Menu Set objective in Stage 1 to a Core Objective in Stage 2.
Capability to submit electronic reportable laboratory results to public health agencies, where except where prohibited, and in accordance with applicable law and practice.
Successful ongoing submission of electronic reportable laboratory results from Certified EHR Technology to a public health agency for the entire EHR reporting period.
Eligible hospitals or CAHS must attest YES to meeting one of the following criteria under the umbrella of ongoing submission:
- Ongoing submission was already achieved for an EHR reporting period in a prior year and continues throughout the current EHR reporting period.
- Registration with the public health agency or other body to whom the information is being submitted of intent to initiate ongoing submission was made by the deadline (within 60 days of the start of the EHR reporting period) and ongoing submission was achieved.
- Registration of intent to initiate ongoing submission was made by the deadline and the EP or hospital is still engaged in testing and validation of ongoing electronic submission.
- Registration of intent to initiate ongoing submission was made by the deadline and the EP or hospital is awaiting invitation to begin testing and validation
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CDC Meaningful Use web site (http://www.cdc.gov/ehrmeaningfuluse)
CMS Meaningful Use web site (http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Stage_2.html)
ONC web site (http://www.healthit.gov/policy-researchers-implementers/meaningful-use-stage-2)
Public Health Information (PHIN) Vocabulary and Distribution System (VADS) (https://phinvads.cdc.gov/vads/SearchVocab.action)
Reportable Condition Mapping Tables (RCMT) (http://www.cdc.gov/ehrmeaningfuluse/rcmt.html)