CalREDIE Electronic Lab Reporting (ELR)
Join the California Department of Public Health transition to electronic laboratory reporting (ELR): Hundreds of clinical laboratories are now engaged in the ELR submission process.
California Reportable Disease Information Exchange Electronic Lab Reporting (CalREDIE ELR) allows organizations to comply with California public health requirements regarding laboratory reporting or reportable conditions through an automated, secure process.
Visit the CDPH HIE Gateway to enroll in ELR: http://hie.cdph.ca.gov
CalREDIE ELR will replace traditional paper-based methods of lab reporting for many reportable diseases and conditions in jurisdictions participating in CalREDIE. Timely reporting via phone call is still required for selected diseases and conditions.
Entities sending laboratory results electronically to CalREDIE will meet California regulations and may satisfy the ELR measure of Meaningful Use.
Getting Started with ELR
- Identify the reportable conditions in the organization's test compendium.
- Map reportable tests, results, and specimens to applicable LOINC and SNOMED codes.
- Ensure that your information system can produce a message compliant with HL7 ELR version 2.5.1, with additional constraints imposed by the CalREDIE ELR2PH Companion Guide (July 2012 Edition).
- Perform structural testing for messages without Protects Health Information (PHI) using the developer tool: web validator.
- Construct logical filters to ensure that only laboratory findings which are reportable to the public health agencies are sent to CDPH.
- Register at the CDPH HIE Gateway and receive all appropriate credentials and instructions necessary for submitting lab reports data electronically to CalREDIE.
- Enrollment: This phase of ELR consists of the orientation process between CDPH and the submitting facility.
ELR Pre-testing: This phase of ELR will include the following activities.
- The submitting facility will enroll for ELR through the CDPH HIE Gateway. A response to the enrollment includes SOAP messaging credentials and a certificate.
User Acceptance Testing (UAT): This phase of ELR consists of correlation of dual method reporting through ELR as well as traditional means, such as fax, US Mail, or other established means.
- The submitting facility will need to demonstrate the ability to transmit a properly formatted ELR message which will pass the CDPH automated message validation as well as receive HL7 acknowledgements.
- HL7 ACK/Nak receipts are returned simultaneously with each message sent to CalREDIE - submitters may find it helpful to retain these receipts.
- Traditional lab reporting continues during this phase, such as fax, US Mail, or other established means.
Maintenance: Entering ELR production marks the transition to the ELR maintenance phase. Submitting facilities must inform CDPH of changes or updates to their ELR messaging, including changes to the test catalog and associated LOINC and SNOMED codes. CDPH will work with the submitter and the local health jurisdiction to facilitate the decision to cease paper reporting.
- When CDPH, the local health department, and the submitter agree that ELRs are acceptable, the submitter will move to ELR production.
- CDPH and the submitting facility will work together to ensure that the logical filters are working properly in terms of sending exactly the reportable results - nothing more and nothing less.
Meaningful Use (MU)
Submitting electronic reportable lab results to public health is one of several measures that may enable hospitals to meet the requirements of MU: http://www.cms.gov/EHRIncentivePrograms/Downloads/9_Reportable_Lab_Results_to_Public_Health_Agencies.pdf
Code of Federal Regulations (CFR) Title 45 Part 164 Section 512 addresses the cases in which a covered entity may disclose individually identifiable health information to a public health authority. 45 CFR. Section 164.512: http://frwebgate.access.gpo.gov/cgi-bin/get-cfr.cgi?TITLE=45&PART=164&SECTION=512&TYPE=TEXT
California Laws and Regulations
The California Health and Safety Code (HSC) Section 120130 paragraph (g), requires laboratories to submit required reports of notifiable diseases electronically to the state electronic reporting. HSC Section 120130: http://www.leginfo.ca.gov/cgi-bin/displaycode?section=hsc&group=120001-121000&file=120125-120155
California Code of Regulations (CCR), Title 17, Section 2505, established under HSC 120130 (a), contains the list of reportable conditions and the requirements for notification by laboratories. CCR Title 17, Section 2505: http://www.cdph.ca.gov/programs/sss/Documents/Title17Sec2505-01-14.pdf
The CalREDIE ELR2PH Companion Guide establishes the California-specific technical supplement to ELR messaging as described in HL7 Version 2.5.1 Implementation Guide: Electronic Laboratory Reporting to Public Health, Release 1 (US Realm) HL7 Version 2.5.1: ORU^RO1. ELR submitters should use the HL7 US Realm Guide in conjunction with the CalREDIE ELR2PH Companion Guide to properly format ELR messages for submission to CalREDIE.
HIV/AIDS Laboratory Information
At this point, CalREDIE ELR is not accepting Electronic Laboratory Results regarding HIV/AIDS information. Potential ELR submitters should program their information systems to prevent sending HIV/AIDS laboratory information until further notice. Reporting entities should continue to report HIV/AIDS information in accordance with the applicable laws and regulations. Please see the Office of AIDS page for more information: http://www.cdph.ca.gov/programs/aids/Pages/Default.aspx
CalREDIE ELR2PH Companion Guide (July 2012 Edition)
HL7 ELR Implementation Guide
CDPH HIE Gateway
Disease Category Checklist
Frequently Asked Questions (FAQs)
Reportable Condition Mapping Table (RCMT)
CCR Title 17 Section 2505 Summary
Health and Safety Code: Section 120130
Meaningful Use Topic: Reportable Lab Results to Public Health Agencies
ELR Implementation Process Reference Guide - May (2014)
For questions or concerns, please contact ELR@cdph.ca.gov