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Electronic
Laboratory Reporting (ELR) Frequently Asked Questions
Q What
constitutes ELR in Texas?
A Electronic Laboratory Reporting (ELR) is the
electronic transmission of results from laboratories that conduct tests for
specific high-profile and/or contagious diseases to public health authorities
so that appropriate actions can be taken to limit the spread and manage impacts
of the disease.
Q Is the Texas (DSHS) accepting ELR data for Meaningful Use?
A Yes, Texas (DSHS) accepts ELR messages from organizations seeking to fulfill their
Meaningful Use public health requirement. For more information, please visit
the http://dshs.texas.gov/mu/elr.aspx webpage.
Q Which entities in Texas should submit ELR messages
during Meaningful Use Stage 1 and Stage 2?
A ELR data is accepted from
eligible hospitals and critical access facilities. If you are interested in
reporting data to Texas (DSHS), please complete registration form at the https://www.dshs.state.tx.us/nedss/forms/Public-Health-Gateway-Provider-Registration-Form.aspx
Q What type of lab tests results should be
submitted?
A Notifiable
conditions (any laboratory examination of a specimen derived from a human body
which yields microscopic, cultural, serological, antigenic or other evidence of
a reportable disease) should be reported according to the implementation
guidelines provided above. A list of reportable conditions is available at Notifiable Conditions.
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?
A Texas is a
dual reporting state, therefore it is required that every ordering facility
report cases of notifiable conditions to DSHS. EHs and CAHs should submit
positive test results for reportable conditions for which they have information
in their EHR whether the actual test was performed in their hospital lab or if
a sample was sent to a reference lab for testing.
Q What HL7 versions can DSHS NEDSS ELR currently receive for ELR?
A DSHS NEDSS ELR is currently able to receive both HL7 2.3.1
and HL7 2.5.1 for ELR following the respective standards and implementation
guides. DSHS NEDSS expects messages to
be formatted based on the following hierarchy.
Q Do you require the use of standard vocabulary?
A Yes, we require the use of
standard vocabulary and value sets, including but not limited to LOINC, SNOMED,
and UCUM. LOINC codes and associated descriptions are required for all
observation identifiers (OBX-3). DSHS NEDSS expects all coded observations values (OBX-5) to use SNOMED codes
and associated descriptions. This applies to all ordinal results such as
positive and reactive as well as nominal results for organism names. This does
not apply to numeric or structured numeric observation values.
Q Why am I required to submit the vocabulary worksheet to DSHS
NEDSS?
A DSHS NEDSS has
found that vocabulary is one of the most time-intensive aspects of ELR
validation. To expedite that process, DSHS NEDSS has
worked vocabulary validation into the ELR on-boarding process. During this validation,
we will
work with your facility to ensure only reportable lab results are being sent,
verify the tests that are performed in-house and those performed by reference
laboratories, confirm that the LOINC and SNOMED codes being sent are valid and
descriptions are accurate, check for internal consistency between LOINC code,
result type, and specimen source, and work out potential content issues on the
front-end.
Q What web based tools are available to assist me in validating my
message structure?
A DSHS NEDSS
uses free, on-line ELR message tools to assist in
validation. Examples include the NIST HL7 2.5.1 Validation Suite for certifying
2014 Edition Meaningful Use EHR technology and the CDC’s Message Quality Framework (MQF) tool.
Q What methods of transport are available to send ELR to DSHS NEDSS?
A Secure
file transport protocol, or SFTP and Public Health Information Network Messaging
System, or PHIN-MS. (SHS NEDSS does not establish secure transport with facilities until the
initial pretesting with the NIST Tool is completed and most structural message
errors have been resolved).