What is Electronic Laboratory Reporting (ELR)?

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 take place to limit the spread and manage impacts of the disease.  ELR has many benefits, including improved timeliness of results, reduction of manual data entry errors, and reports that are more complete.

About Disease Surveillance

Detecting and monitoring the occurrence of disease through reporting of test results for notifiable conditions is a cornerstone of public health surveillance in Texas. The National Electronic Disease Surveillance System (NEDSS) Electronic Laboratory Reporting (ELR) system at the Texas Department of State Health Services (DSHS) provides a method for hospital and clinical laboratories to electronically submit test results to fulfill their statutory obligation to report test results to the public health authority.

Submitting ELR Data to Meet Public Health Reporting Requirements under Meaningful Use Programs

While all hospitals and clinical laboratories may participate in ELR, Eligible Hospitals (EHs) or Critical Access Hospitals (CAHs) participating in the Centers for Medicare and Medicaid Services’ Electronic Health Record Incentive Programs may use their successful participation in ELR reporting using Certified Electronic Health Record Technology (CEHRT) to help meet EHR Incentive Programs’ requirements for reporting data to public health.

In order to meet the EHR Incentive Programs’ requirements for ELR reporting, participating EHs and CAHs must be actively engaged with public health and use CEHRT that is capable of sending ELR messages consistent with identified specifications.  Participants in Stage 2 must be compliant with the specifications in the HL7 Version 2.5.1 Implementation Guide: Electronic Laboratory Reporting to Public Health, Release 1.

Active Engagement

There are two ways an EHR Incentive Program participant can be “actively engaged” in ELR reporting:

Active Engagement Option 1: Pre-production and Validation: The eligible hospital or CAH registered to submit data with the PHA or, where applicable, the CDR to which the information is being submitted; registration was completed within 60 days after the start of the EHR reporting period; and the eligible hospital or CAH is awaiting an invitation from the PHA or CDR to begin testing and validation. Then, the eligible hospital or CAH begins the process of testing and validation of the electronic submission of data. Eligible hospitals or CAHs must respond to requests from the PHA or, where applicable, the CDR within 30 days; failure to respond twice within an EHR reporting period would result in that eligible hospital or CAH not meeting the measure.

Note: This option allows eligible hospitals or CAHs to meet the measure when the PHA or the CDR has limited resources to initiate the testing and validation process. Eligible hospitals or CAHs that have registered in previous years do not need to submit an additional registration to meet this requirement for each EHR reporting period.

Active Engagement Option 2: Validated Data Production: The eligible hospital or CAH has completed testing and validation of the electronic submission and is electronically submitting production data to the PHA or CDR.

Production Data: Refers to data generated through clinical processes involving patient care, and it is used to distinguish between data and “test data” which may be submitted for the purposes of enrolling in and testing electronic data transfers.

The Texas DSHS ELR Onboarding Guide describes the ELR onboarding process and the DSHS requirements in detail.

Other Resources

• HL7 Version 2.5.1 Implementation Guide: Electronic Laboratory Reporting to Public Health, Release 1
• Public Health Information (PHIN) Vocabulary and Distribution System (VADS)
• HL7 Implementation Guide
• LOINC (Common LOINC Result and Universal Order Codes)
• SNOMED
• For the layout of messages to DSHS, email nedss@dshs.texas.gov.

Additional Questions

Contact IDI@dshs.texas.gov for questions and more information.

For information on the DSHS electronic case reporting (eCR) initiative, visit the Electronic Case Reporting (eCR) page.