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CSTE National ELR Workgroup

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Becky Lampkins, Manager, Surveillance/Informatics Program at CSTEMegan Toe, CSTEScott Troppy, Surveillance Epidemiologist at MA DPHMeredith Lichtenstein, CSTEAmy Drake, NMJohn RobertsNancy Barrett, Epi 4/PH Informatics SpecialistErin Holt, TDHRita Altamore, EpidemiologistDavid DiCesareJason HallWalter Kemper, ELR Coordinator, NC DHHS Div of Public HealthJulie LuepkeCarmen Pugh, Labcorp Manager State Reporting at LabCorpTom Safranek +399 others
Posted by Nancy Barrett ·

COVID 19 Antigen testing questions

Hi all,
AS you may know, antigen test results are now part of the CSTE most recent position paper on COVID-19. Also, I've been told and another sate said also, that nursing homes/LTCF will be receiving Quidel Sofia Ag testing instruments, but may not have ways to connect to a computer to send files, but instead will need to report by paper/fax. We have a possible way to add this to a portal our LTCFs are using to report patients with positive PCR results, but they don't have to submit negative results. 

Any thoughts from our CDC/CSTE partners on this situation? Since antigen testing will likely increase given the ability to do POC testing and to increase testing coverage, how do we as the PHAs capture these results that must be reported to us, and we must report to the CDC?

Nancy

Comments & Events

Riki Merrick, Terminologist at APHL Riki Merrick, Terminologist at APHL
another use case for the Flatfile Hl7 generator tool?!

Riki
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Nancy Barrett, Epi 4/PH Informatics Specialist Nancy Barrett, Epi 4/PH Informatics Specialist
if they could generate a flat file to start with, which we've heard they won't be able to.
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Riki Merrick, Terminologist at APHL Riki Merrick, Terminologist at APHL
Can they fill in an excel sheet?

Riki
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Nancy Barrett, Epi 4/PH Informatics Specialist Nancy Barrett, Epi 4/PH Informatics Specialist
You know, I don't know as I've just heard this is going to be occurring, but don't know if any of the LTCF have started using. I know they have very limited computer resources, but we may have a portal option, which then renders that moot as we'll put that into our surveillance system directly. But for other labs, that may be a solution in general.

I was more concerned with why distribute test instruments with no ability to connect to a pc/EHR etc.
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Mark Dittman Mark Dittman
Rikki,

It’s not a matter of “can” it is always the question of “will” they fill out, report, comply with regs, be decent…. Blah blah and the answer is mostly “no, thanks because….”. And where an export option may exist with some of these machines the answer will be “sure, give me the money to buy that add on…” or “hire someone to…”. I’ve had four emails just up until noon today of different LTCs that are sending out to labs we’ve never heard of and they’ve been testing for how long while not reporting?

Mark
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Jason Hall Jason Hall
I think the focus is to be able to test the residents tested, and quickly, to protect everyone in those settings. Data wasn’t the focus. So the distribution is for the patients, not the data. That said, everyone will assume the data are going to be reported. We’ve talked once with the NH association and everyone understands reporting isn’t ready out of the box. We’re working on some ways to help get them flowing. Just possibilities at this point.
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Sita Smith Sita Smith
We do have a bunch of LTCFs who submit flat files, but very basic ones (no way are they going to be using Riki's all-singing-all-dancing one, beautiful though it is) and they struggle with that. we see a lot of data entry errors.
One solution would be to have the vendors set up the facility and market it as a selling point, no? A lot of these machines do have some basic reporting capacity, but they don't offer the POC too many options to change reports, because the reports are pre-packaged. 
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Kate Goodin, Surveillance Systems and Informatics Program Director Kate Goodin, Surveillance Systems and Informatics Program Director
Isn’t Quidel Sofia WiFi enabled and reporting back to the vendor database? That was my understanding from some conversations with the vendor years ago about using their platform to do RSV surveillance locally and as part of ILINet. Have there been discussions about the vendor doing centralized reporting?

-Kate
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Jason Hall Jason Hall
Quidel does have their Virena data platform. Not all their customers have opted in to sending data there. I understand it, Quidel has made it a requirement for all new customers to opt in. All this said, no patient identifiers are on the machines and none are being sent to Virena. I think the closest you’ll get is the cartridge id. There are a lot of data on it though…I have a list of data variables for those interested.


Jason
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Annie Fine Annie Fine
Hi Kate - my understanding is that they cannot send identifiable data to the vendor so there is no way to use these reports as ELR or disease reporting.
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Nancy Barrett, Epi 4/PH Informatics Specialist Nancy Barrett, Epi 4/PH Informatics Specialist
Hi Kate, never heard of this! I'd like more information. 

Jason -- is there enough data to use in a CELR report? We'd have to store this data outside of our surveillance system, but just wondering. But if every site does not send to Virena then not sure how helpful this would be??

Second question - is it worth a call to review the latest interim guidance and also see how this impacts any diagnostic or screening algorithms. And Appendix 1 on epi classification of work-relatedness? with the folks capturing lab and case data?

third question -- will COVID-19 become part of ILI surveillance?
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Jason Hall Jason Hall
For #1: It depends on the device…not all have extant or rich data platforms. Quidel does have their Virena data platform. Not all their customers have opted in to sending data there. As I understand it, Quidel has made it a requirement for all new customers to opt in, but not all existing ones. All this said, no patient identifiers are on the machines and none are being sent to Virena. I think the closest you’ll get is the cartridge id. There are a lot of data on Virena though…I have a list of data variables for those interested.

Questions #2 and #3 aren’t my lane, but for #3, we have a signed DUA and are bringing in Quidel data on AIMS for CDC use, so probably for ILINet.


Jason
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