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Tools and References
Tools for Implementing ELR in Oregon
  • OHA Manual for Mandatory Electronic Laboratory Reporting: This document is available by request and contains specific details for setup of ELR in Oregon. Please contact us to request your copy.
  • Laboratory Reporting Poster (pdf)
    Note: poster size is 11x17"
  • Oregon's HL7 2.5.1 ELR Implementation Guide (pdf)
    For a comprehensive guide on ELR message construction, visit HL7.org.
  • Mapper’s Guide for the Top 2000 plus LOINC Laboratory Observations
    Visit the LOINC web site to download the "Mapper’s Guide for the Top 2000 plus LOINC Laboratory Observations." You will need to register on the LOINC site, and then you can download the Mapper's Guide either as a pdf or excel file.
  • Reportable Condition Mapping Tables (RCMT)
    Tables containing mapping between reportable conditions, LOINC test codes, and SNOMED result codes, developed by the Standards Workgroup under the CDC/CSTE Electronic Laboratory Reporting (ELR) Task Force are available at http://phinvads.cdc.gov/

Oregon Public Health Meaningful Use

ELR is a Stage 1 Meaningful Use menu objective for Eligible Hospitals in Oregon and will be required for Stage 2 (which begins in October 2013 for Medicare and January 2014 for Medicaid Eligible Hospitals).

Why choose ELR? ELR data are critical to Public Health disease surveillance programs and thus to population health. ELR provides a one-stop dropoff point for laboratories to submit reportable data: incoming laboratory data are translated, processed, and automatically routed to appropriate public health recipients (Local Health Departments and state program areas) by state ELR. To meet MU requirements, laboratory data must be sent from an ONC certified EHR (which usually includes Laboratory Information Systems (LIS)). Read more...


Laboratory Reporting Requirements

Refer to the OARs and the Laboratory poster (pdf) for the definitive and complete information regarding updates. Here are a few highlights to keep in mind:

New reportables have been added:

  • Enterobacteriaceae family isolates found to be non-susceptible to any carbapenem antibiotic - see CRE poster (pdf) for details. Genera to exclude from CRE ELR: Proteus, Providencia, Morganella, or Pseudomonas.
  • Cryptococcus
  • Hepatitis E
  • Change in wording: All blood lead testing results [are reportable], but lead poisoning (blood lead level of at least 10 micrograms per deciliter) should be reported within one local health department working day

Other Disease Reporting Information

Cryptococcus Reporting Information, from State Veterinarian, March 2012

All of the following tests are now reportable:

  • Cryptococcal culture
  • Cryptococcal antigen (CSF and blood), and antibody (complement fixation and immunodiffusion)
  • Cryptococcal identification on slides, paraffin blocks
Cryptosporidiosis Reporting Information, from HAN Alert 4763, January 2012
"We have updated our case definitions regarding the diagnosis of cryptosporidiosis according to the national standards. We want to remind Oregon laboratories that the Immunostat card test is not sufficient to confirm a case of cryptosporidiosis."
 
Hepatitis Case Definitions Information, provided by state Hepatitis Coordinator, January 2012

"The case definitions for hepatitis A, B and C have been updated to reflect the recommendations made by the Centers for Disease Control and Prevention (CDC) and the Council of State and Territorial Epidemiologists (CSTE). These changes are effective as of January 1st, 2012.

Updated Investigative Guidelines for hepatitis A, B and C include:

  • Elimination of presumptive hepatitis A case definition
  • Confirmed acute B cases require jaundice or ALT levels >100 IU/L
  • Asymptomatic seroconversion has been included in the case definition for acute hepatitis B and C
  • Presumptive chronic C cases must have elevated ALT levels
  • Suspect case definition added for chronic C - all cases with a single positive anti-HCV result with no s/co ratio available or ALT are now considered suspect cases"

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