Electronic Laboratory Reporting (ELR)

Due to the high volume of COVID-19 testing the ELR team has limited capacity. To report COVID-19 test results, please review the steps below on submitting HL7 or reference the National Flat File webpage if your staff are unfamiliar with HL7. DOH has created FAQs for items related to COVID-19, reporting requirements and WA progress. For more information, please email ELR@doh.wa.gov.

Electronic Laboratory Reporting (ELR) is the electronic transmission from laboratories to public health of laboratory reports that identify notifiable conditions. The Washington State Department of Health maintains an ELR system, which provides data to public health disease investigators across the state via the state surveillance system.

Expansion of ELR improves public health surveillance capabilities.

ELR-specific Notifiable Conditions Rule Revision Implementation

Supplemental guidance is available to assist production ELR submitters with the WAC changes to electronic laboratory reporting requirements upcoming on January 1, 2023.

Information for Promoting Interoperability (Previously Meaningful Use) Eligible Hospitals

Eligible Hospitals who need their annual attestation letter, please send an email to elr@doh.wa.gov.

Information for submitting lab data to WA DOH via ELR

Washington state requests ELR data standardized to HL7 v2.5.1. The preferred method of submitting this to DOH is through our HIE (Health Information Exchange) who is OneHealthPort.

If you are unable to create HL7 v2.5.1 messages, and you are submitting COVID-19 results only, you may use the National Flat File.

Note: All data submitters must continue traditional reporting practices (i.e., fax, mail) during implementation of electronic laboratory reporting until they complete all onboarding and quality assurance processes. Do not turn off traditional reporting methods until notified to do so.

Onboarding Process

Step 1. Registration

Register intent to submit electronic laboratory reporting data to public health.

Step 2. Pretesting

Create ELR messages following the below requirements:

Map LOINC and SNOMED codes:

Follow Washington Administrative Code (WAC) reporting requirements:

Generate and pretest ELR test messages using the National Institute of Standards and Technology (NIST) validation tool. Please test each of the following result types:

  • Coded result
  • Numeric result
  • Structured numeric result (if produced by your system)
  • Text result (if produced by your system)

Once the context-free validation reports indicate the test messages are free of errors, send notice to ELR@doh.wa.gov of ability to submit HL7 messages

  • Email is not a secure mechanism of data transfer. Do not email personally identifiable health information.

Step 3. Connectivity

The OneHealthPort Health Information Exchange (HIE) is the required method of ELR data transport to DOH. Work with OneHealthPort to set up your HIE connection. Email to inform of successful connection.

Step 4. Validation Queue

Entities who have successfully set up HL7 and connectivity are placed into the validation queue. The length of the queue has grown as more entities have signed up due to COVID-19 reporting; wait times have increased over time. Once a submitter reaches the front of the queue, they will be invited by agency staff to begin submitting data and move on to validation.

Step 5. Validation

Structural Validation

In the first stage of validation, Department of Health staff will review the structure of your ELR messages. This review checks to make sure your messages follow HL7 standards as required in the HL7 Version 2.5.1 ELR Implementation Guide; WA supports ELR 2.5.1 release 1.

Content Validation

Once any structural validation issues are addressed, the second stage of validation can begin. Content validation consists of ongoing parallel validation of your ELR messages. ELR messages must meet reporting requirements established in the HL7 Version 2.5.1 Implementation Guide (ELR 2.5.1 release 1 is supported) and WAC Chapter 246-101. During content validation, ELR messages will be assessed for accuracy of data, completeness of reporting, timeliness of reporting, and correct jurisdictional routing.

All issues identified during the validation process must be addressed before an entity can move to production reporting. If you have any questions or would like further information about validation, please contact us.

Step 6. Production

Once an eligible hospital has completed validation, they will receive an acknowledgement of their success and be placed into production status. At this point, eligible hospitals may discontinue traditional reporting of non-immediately notifiable conditions, as well as discontinue sending parallel paper for validation.

Note: ELR does not meet the time frame required by Washington State law for reporting immediately notifiable conditions.

  • Even if an eligible hospital is participating in ELR, all results that are immediately notifiable must continue to be reported by phone.

Eligible hospitals will be required to participate in periodic quality assurance checks to ensure accuracy of reporting. Department of Health staff will contact data providers to schedule these activities.