Electronic Laboratory Reporting (ELR) Onboarding Process

After completion of registration a confirmation email is sent detailing the next steps in the process and the facility is placed in the onboarding queue. Each facility in the queue is evaluated and ranked based on readiness, volume, HL7 capability, and a few other key factors. Submitters in the onboarding queue will be contacted by the Onboarding Coordinator when DOH has dedicated resources available for onboarding.

While preparing for the onboarding process DOH requires the completion of the following items prior to next steps:

• Complete the ELR Onboarding Questionnaire online or word document and return within two weeks of registering intent to onboard:
  • ELR Onboarding Questionnaire
  • ELR Onboarding Questionnaire (docx)
• Familarize your team with the WA State ELR Onboarding Manual (PDF)
• Identify a project manager, interface and lab analysts, vendor technical consultant and/or lab director representative, compliance representative, and IT specialist working on the ELR implementation who will attend the kickoff call.
• DOH ELR requires the use of LOINC and SNOMED CT codes for lab orders and results. If your organization has not mapped local codes to the LOINC or SNOMED codes for each reportable condition, we will delay onboarding until this is complete. There are no exceptions to this requirement.
• Familiarize yourself with Washington Administrative Code (WAC) 246-101 for all reportable conditions.
  • Laboratory Directors Duties
  • Content of Laboratory Reports
  • General Reporting Questions
  • Notifiable Conditions with Provisional Reporting Notifications

Onboarding Steps

1. Registration

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

2. Pretesting

Create ELR messages following the requirements

• HL7 Version 2.5.1 ELR Implementation Guide (WA supports ELR 2.5.1 release 1)
• HL7 Message Header Segment (MSH) for Washington State ELR (supplemental) (PDF)

Map LOINC and SNOMED codes

• Reportable Conditions Mapping Tables (RCMT)
• Specimen Type SNOMED Value Set

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 Results
• Numeric Results
• Structured numeric results (if produced by your system)
• Test Results (If produced by your system
  
  Once the context-free validation reports indicate the test messages are free of errors, send notice to dataexchange@doh.wa.gov of ability to submit HL7 messages.Coded result Numeric result Structured numeric result (if produced by your system) Text result (if produced by your system).

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

3. Connectivity

OneHealthPort Health Information Exchange (OHP) is the Washington State Health Information Exchange (HIE) and DOH preferred transport method. Washington State's Health Information Exchange provides healthcare organizations a secure, low-cost means to share standardized messages with trading partners on a system-to-system basis. 

• To begin register here OHP HIE Support Request Form - Formstack to submit a ticket, select “HIE Contracting” under the Support Request action. Type “We would like to begin submitting ELR data to WA DOH" into the text box that appears.
• There is a nominal fee to use this service.
• OHP distributes clinical data to multiple DOH agencies including Syndromic Surveillance, Immunizations and Cancer Registry in addition to ELR.

AIMS Platform (aphl.org) APHL Informatics Messaging Services (AIMS): AIMS is a secure, cloud-based platform that accelerates the implementation of health messaging by providing shared services to aid in the visualization, interoperability, security and hosting of electronic data.

• To begin, complete intake form here AIMS Centralized ELR Customer Intake Form. AIMS distributes test results to all states.
• Once the Healthcare Organization is onboarded with AIMS, they must continue to report manually to WA DOH until ELR is onboarded into our Production environment. Going live with AIMS does not mean you are live with WA DOH.

4. 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.

Entities who have successfully set up HL7 and connectivity are placed into the validation queue. 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.

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.

5. 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.

Contact Information

For questions about ELR Onboarding, please contact dataexchange@doh.wa.gov

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