Electronic Laboratory Reporting

Electronic Laboratory Reporting (ELR) Overview

Electronic Laboratory Reporting (ELR) is a secure method to automatically send laboratory test results for reportable conditions to the North Dakota Department of Health and Human Services (NDHHS). It allows laboratories to share critical data, such as test results, patient demographics, and provider information. ELR helps public health agencies receive data faster and reduces errors from manual data entry. This makes reporting more complete and helps public health officials quickly respond.

NDHHS can receive ELR messages for mandatory reportable diseases. A full list is available on our website.

Steps for Getting Started with ELR

Review the NDHHS ELR Condensed Specification to help determine your readiness to start. NDHHS will be available to provide some help with coding reportable conditions. However, the hospital, lab, and EHR staff will be responsible for most of the coding and implementation.

  1. Set up your ELR message transport route. The preferred method is connection with the North Dakota Health Information Network (NDHIN).

  2. Complete EHR or LIMS validation to ensure your system captures all required data elements and uses standard codes when possible. NDHHS prefers standard LOINC and SNOMED codes.

  3. Confirm the messages follow HL7 standards. HL7 2.5.1 is preferred, and the detailed specification guide is available on the HL7 website. ELR messages must pass the National Institutes of Standards and Technology (NIST) HL7 validation tool. The Message Evaluation and Testing Service (METS) validation tool is also available.

  4. Complete content validation with NDHHS staff. This includes identifying resources, reviewing roles, mapping fields, and reviewing the testing process.

  5. Complete testing with NDHHS.

  6. Once approved, move to go-live and begin sending ELR messages to the NDHHS production environment.

Traditional disease reporting must continue until both the laboratory and NDHHS have verified that the new electronic reporting production environment is working correctly.

Please note that any high priority cases still need to be reported immediately by calling 800-472-2180 or 701-328-2378, 711 (TTY).

Tools and Standards

To learn more about implementing ELR and the standards, please visit these resources:

  • HL7 Version 2.5.1 Implementation Guide is the standard for compliance with the Centers for Medicare and Medicaid Services, Health and Human Services, and Promoting Interoperability Program criteria for electronic submissions of lab results to public health agencies.
  • Logical Observation Identifier Names and Codes (LOINC®) is the standard for specific laboratory procedure names.
  • Systematized Nomenclature of Medicine (SNOMED®) is the standard for descriptions of findings, specifically for organism names.
  • Reportable Condition Mapping Tables (RCMT) can be used for mapping between reportable conditions, LOINC test codes, and SNOMED result codes.

If you have questions, please contact us at disease@nd.gov or 701-328-3278, 711 (TTY).