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The Oregon ELR Project

About Electronic Laboratory Reporting

Historically, communicable disease reporting to state and county health departments was paper-based, relying heavily on FAX, telephone and snail mail. Today's sophisticated laboratory information systems bring an opportunity to move toward more timely and efficient electronic laboratory reporting. ELR data are critical to Public Health disease surveillance programs and thus to population health.

The Oregon ELR Project provides a one-stop drop-off point for laboratories to submit reportable data using electronic data interchange. In this system, the Public Health Division functions as an electronic hub to accept, route, and process electronic HL7 messages containing lab and clinical data. View a graphic that describes Oregon ELR Data Flow (pdf).


ELR Legally Mandated for High-Volume Laboratories


COVID-19 ELR Reporting

  • US Health and Human Services reporting guidance has been updated to remove the requirement to report negative results for COVID-19 tests authorized for use under a CLIA certificate of waiver as of April 4, 2022. This includes COVID-19 rapid PCR and antigen test.
    The updated guidance continues to require laboratories certified under CLIA to perform moderate or high complexity test to report both positive and negative COVID-19 results for nucleic acid amplification tests

  • Laboratories that are performing COVID-19 Genetic Sequencing from a human specimen must report the results to the Oregon Health Authority in accordance with the Electronic laboratory Reporting Manual's direction. Any laboratory that performs genetic sequencing of SARS-CoV-2 from a human specimen shall, within 24 hours of completion of the genetic sequence analysis, report to OHA electronically in accordance with the Authority's Electronic Laboratory Reporting (ELR) Manual, the following:

    • Required elements in the electronic reports
    • The identity of any SARS-CoV2 sequence designated by the federal Centers for Disease Control and Prevention as a Variant of Concern or a Variant of High Consequence
    • The GISAID Accession ID, if known

  • The request to submit 'Ask On Entry' responses with COVID-19 results has been retracted. For official guidance, please see CDC's 'How to Report' COVID-19 page.

  • COVID-19 REALD reporting requirement: REALD must be collected utilizing a standardized questionnaire and submitted in one of the approved reporting options for all COVID-19 encounters.    

Specifications

  • Oregon's HL7 2.5.1 ELR Implementation Guide (pdf). For a comprehensive guide on ELR message construction, visit HL7.org.
    • HL7 2.5.1 is the only acceptable standard for meeting Promoting Interoperability requirements.

  • We understand that sites without a Laboratory Information Sytem or Electronic Health Records may not be prepared to submit HL7 data for reporting.  Please review the Oregon's CSV (Alternative Format) ELR Implementation Guide (pdf) and request approval to use this format from our onboarding team.
    • This template (last updated Aug 2020) may be used to help you construct your message. All columns are required to be present even if not populated and format requirement from the CSV implementation guide must be followed.

Tools and Standards

  • Logical Observation Identifier Names and Codes (LOINC®) for specific laboratory procedure names
  • Systematized Nomenclature of Medicine (SNOMED®) for descriptions of findings, specifically for organism names
  • Reportable Condition Mapping Tables (RCMT) for mapping between reportable conditions, LOINC test codes, and SNOMED result codes.

Additional Resources


Public Health Promoting Interoperability (aka, Meaningful Use)

ELR is a required Promoting Interoperability measure for eligible Hospitals and providers in Oregon. To meet MU requirements, laboratory data must be sent from an ONC certified Electronic Health Record System (EHR) or Laboratory Information Systems (LIS). Read more about Oregon Public Health Meaningful Use.