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Electronic Laboratory Reporting

Purpose

Electronic Laboratory Reporting (ELR) is the electronic transmission of laboratory reports which identify reportable conditions from laboratories to public health. Nevada Department of Public and Behavioral Health (DPBH) has implemented an ELR system to receive reportable disease results from clinical laboratories and place them into the epidemiology program surveillance databases. The ELR system receives standardized HL7 messages containing results from reference laboratories, eligible hospitals and critical access hospitals. These reportable lab results are parsed to the appropriate state disease surveillance program based on LOINC and SNOMED codes. 

ELR will replace paper-based reporting for notifiable conditions upon the completion of registration, onboarding preparation, validation, and going live in production. ELR offers lasting benefits to both laboratories and public health agencies. 

Steps for Hospitals or Other Reporting Provider

When a hospital or reporting provider is ready to set up electronic laboratory reporting for Promoting Interoperability, the following process will be utilized: 

  1. Hospital implements certified Electronic Health Record (EHR) technology capable of sending ELR messages to public health. ELR messages for Promoting Interoperability must follow the HL7 Version 2.5.1 Implementation Guide: Electronic Laboratory Reporting to Public Health, Release 1 and include LOINC codes. SNOMED CT codes are required by Nevada Department of Public and Behavioral Health (NV DPBH) for messages which contain a non-organism specific LOINC code. 
  2. Test HL7 messages on the National Institute of Standards and Technology’s (NIST) HL7 Testing site. Select the ELR receiver profile link. 
  3. Contact the ELR Coordinator to determine timelines and start the interoperability process. 
  4. Hold a kickoff meeting with appropriate hospital staff, vendor and the ELR Team. This kickoff can be in person, web conference, or a combination of both and may be combined with a work session. During the work session the ELR Implementation Team will provide assistance with HL7 validation, required vocabulary, and Secure File Transfer Protocol (SFTP) setup. By the end of the work session a hospital or reporting provider should be able to send a validated ELR message from the EHR to the NV DPBH Office of State Epidemiology (OSE) using a SFTP connection and meet the stage 1 test for Promoting Interoperability. If the testing phase is successful, ongoing transmission should be set up and the “parallel validation” phase will be completed. 
  5. The ELR Team at DPBH will conduct a “parallel validation” of the electronic lab reports to the reports sent using another method (fax, mail, and web entry). 
  6. After successful “parallel validation” the ELR messages will be sent to the OSE production surveillance systems and the other reporting method (fax, mail, and web entry) can be terminated, upon approval by the appropriate NV DPBH Program(s). There are several Programs at OSE that receive ELR data, including general communicable disease, STD, HIV, Lead, and Cancer. The timelines for discontinuing other reporting methods for these program areas may vary.

For additional information on ELR and promoting interoperability, or if you are ready to set up ELR interoperability onboarding, please contact us: informatics@health.nv.gov. 

Resources

Required Standards 

Tools