ELR is the electronic transmission of laboratory test results of notifiable conditions from laboratories to public health authorities so that appropriate actions can be taken to limit the spread and manage impacts of the disease.
Yes, Texas (DSHS) accepts ELR messages from organizations seeking to fulfill their CMS PIP public health requirement. For more information, visit the http://mu/elr.aspx webpage.
ELR data is accepted from eligible hospitals and critical access facilities. If you are interested in reporting data to DSHS, complete and submit this ELR Provider Registration Form.
To register your facility, go to ELR Provider Registration Form, and if you need to register multiple facilities, then complete the facility bulk registration template and submit through the registration.
Texas Notifiable conditions should be reported according to the Texas ELR Onboarding Guide. implementation guidelines provided above. A list of reportable conditions is available at Notifiable Conditions.
The National Electronic Disease Surveillance System (NEDSS) ELR system at DSHS is the single point of contact for laboratory and case result reporting indicative of notifiable conditions. For assistance, contact IDI@dshs.texas.gov. The DSHS IDI staff will provide eligible providers and hospitals (or hospital systems/healthcare organizations) with data format specifications and will schedule technical assistance as needed.
Communicable disease reporting is mandated in Texas Health and Safety Code. By statute, any laboratory that conducts reportable laboratory test(s) and the facility that orders such tests are responsible for reporting diseases and conditions to the DSHS by Texas Health and Safety Code Sec. 81.042.
For Promoting Interoperability Program (PIP), the acceptable format for DSHS NEDSS ELR is HL7 2.5.1 following the respective standards and implementation guides.
Yes, we require the use of standard clinical vocabulary and value sets, including but not limited to Logical Observation Identifiers Names and Codes (LOINC), Systematized Nomenclature of Medicine (SNOMED), International Classification of Diseases (ICD)-10 and Unified Code for Unified Measures (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 IDI team 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.
DSHS IDI team uses online ELR message tools to assist in validation. Examples include the ELR Validation Tool @ NIST for initial validation and error count.
Secure file transport protocol (sFTP), or FTP, S3 and Public Health Information Network Messaging System (PHIN-MS). DSHS IDI team 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.