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Meaningful Use

Electronic Lab Reporting (ELR)

The Arizona Electronic Lab Reporting (ELR) for Meaningful Use Workshop on May 17 was a success!
Informational FlyerPDF | AgendaPDF | Workshop Materials: Part 1, Part 2, Part 3Zip
(Session recordings available soon.)

The Arizona Department of Health Services is currently accepting electronic submissions of reportable lab results for meaningful use.


Electronic Laboratory Reporting (ELR) is the electronic transmission of laboratory reports which identify reportable conditions from laboratories to public health. ADHS has implemented an Electronic Laboratory Reporting (ELR) system to receive reportable disease results from clinical laboratories and place them into the epidemiology program surveillance databases, including the Medical Electronic Disease Surveillance Intelligence System (MEDSIS). The ELR system receives standardized HL7 messages containing results from reference laboratories and hospitals. These reportable lab results are parsed to the appropriate state disease surveillance program based on LOINC and SNOMED codes.

For Eligible Hospitals (EHs) and Critical Access Hospitals (CAHs) the Stage 1, meaningful use objective and measure for reportable lab results are:

  • Objective: Capability to submit electronic data on reportable (as required by State or local law) lab results to public health agencies and actual submission according to applicable law and practice.
  • Measure: Performed at least one test of certified EHR technology's capacity to provide electronic submission of reportable lab results to public health agencies and follow-up submission if the test is successful.

Steps for Hospitals

When a hospital is ready to set up electronic laboratory reporting for meaningful use, the following process will be utilized:

  1. Hospital implements certified EHR technology capable of sending ELR messages to public health. ELR messages for meaningful use must follow the HL7 Version 2.5.1 Implementation Guide: Electronic Laboratory Reporting to Public Health, Release 1 (available on the HL7 website) and include LOINC codes. SNOMED CT codes are required by ADHS for messages which contain a non-organism specific LOINC code.
  2. Test HL7 messages on CDC’s Message Quality Framework site. Select the ELR receiver profile link.
  3. Contact the ADHS ELR Coordinator to determine timelines and start the interoperability process.
  4. Hold a kick-off meeting with appropriate hospital staff, vendor and ADHS ELR Implementation Team. This kick-off can be in person, web conference, or a combination of both and may be combined with a work session. During the work session the ADHS ELR Implementation Team will provide assistance with HL7 validation, required vocabulary, and secure message transport setup. By the end of the work session a hospital should be able to send a validated ELR message from the EHR to ADHS using secure message transport, and meet the stage 1 test for meaningful use. If the test is successful, ongoing transmission should be set up.
  5. The ADHS ELR Implementation Team will conduct a “parallel validation” of the electronic lab reports to the reports sent using another method (fax, mail, and web entry).
  6. After successful “parallel validation” the ELR messages will be sent to the ADHS production surveillance systems and the other reporting method (fax, mail, and web entry) can be terminated. There are several Programs at ADHS that receive ELR data, including general communicable disease, STD, HIV, Lead, and Cancer. The timelines for discontinuing other reporting methods for these program areas may vary.

For additional information on electronic laboratory reporting and meaningful use, or if you are ready to set up ELR interoperability, please contact us.