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:///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).