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 (WELRS), which provides data to public health disease investigators across the state.
Expansion of ELR through meaningful use will improve public health surveillance capabilities.
Information for Eligible Hospitals
Hospitals interested in pursuing the ELR meaningful use objective may work through the onboarding process below.
Eligible hospitals must continue traditional reporting practices (i.e., fax, mail, web submitter) 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.
Step 1. Registration
Register intent to submit electronic laboratory reporting data to public health.
Step 2. Pretesting
Create ELR messages following the below 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:
Follow Washington Administrative Code (WAC) reporting requirements:
- 246-101-201 Notifiable conditions and laboratories.
- Please also reference Rare Disease of Public Health Significance
- 246-101-205 Responsibilities and duties of the laboratory director.
- 246-101-210 Means of specimen submission.
- 246-101-215 Content of documentation accompanying specimen submission.
- 246-101-220 Means of notification for positive preliminary test results and positive final test results.
- 246-101-225 Content of notifications for positive preliminary test results and positive final test results.
- 246-101-010 Definitions within the notifiable conditions regulations.
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 copies of the reports to ELR@doh.wa.gov.
- 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 for Medicaid-eligible hospitals. Work with OneHealthPort to set up your HIE connection, then test connectivity by transmitting at least one ELR message. Once messages route correctly, you will be given the go ahead to continue sending ELR data for validation purposes.
Step 4. Validation Queue
Eligible hospitals who are successfully submitting ELR messages via the HIE are placed into the validation queue. We anticipate the length of the queue will grow as meaningful use progresses; wait times will increase over time. Once an eligible hospital reaches the front of the queue, they will be invited by agency staff to move on to validation.
Step 5. 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.
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 2456-101. 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 eligible hospital 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.
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.