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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

  • In March 2010, Electronic Laboratory Reporting (ELR) became legally mandated for laboratories sending an average of more than 30 records per month to the Public Health Division. For details, please review Oregon Administrative Rules (OARs), Division 18, Disease Reporting.
  • Civil penalties (Civil Penalties for Violations of OAR Chapter 333, Divisions 18 and 19) may be applied if qualifying laboratories failed to seek or obtain ELR approval by March 2011.
  • Reports for an individual who is not an Oregon resident or who does not reside in Oregon may not be made to the Oregon local public health administrator or the Authority, but shall be made to the jurisdictional public health authority of the patient's residence. Permanent changes to OAR, Division 18, 333-018-0005, (3) were effective 3/23/21.
  • 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

Specifications

  • Oregon's HL7 2.5.1 ELR Implementation Guide (pdf). For a comprehensive guide on ELR message construction, visit HL7.org.
    • NEW!! This guide is being revised to align with CDC guidance for COVID-19 AOE requirements. We are doing our best to keep this up to date. For official guidance, please see CDC's How to Report COVID-19 page.
    • HL7 2.5.1 is the only acceptable standard for meeting Promoting Interoperability requirements.
    • While Oregon supports HL7 2.3 messages, we encourage submitters to adopt the 2.5.1 standard. For earlier versions, please visit HL7.org.
  • We understand that not all sites are prepared to submit HL7 data for reporting, especially those sites doing on Oregon's CSV (Alternative Format) ELR Implementation Guide (pdf) with approval 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.

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 (formerly, Meaningful Use) measure for Eligible Hospitals in Oregon. To meet MU requirements, laboratory data must be sent from an ONC certified EHR (which usually includes Laboratory Information Systems (LIS)). Read more about Oregon Public Health Meaningful Use...



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