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.
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.
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.
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.
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.
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.
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.
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).