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CSTE National ELR Workgroup

Welcome to the CSTE National ELR Workgroup Basecamp! We hope you will utilize the space to share resources with colleagues, start discussion threads, and identify topics for the workgroup to tackle on future calls. All workgroup members will have the opportunity to join. Please note that you may edit your notification preferences to suit your needs (and your email inbox). If you are not already on the ELR distribution list and would like to receive call communications, please enroll using this subscription form (copy and paste in browser): https://app.smartsheet.com/b/form/5a91a4579952496682084796b82112e6
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 Jennifer Floch ·

HBV Labs

Good afternoon. This is Jennifer from MT. We are looking to change what labs we receive for Hep B through our ELR, and I was wondering what other states do regarding Hep B labs. Do you receive only positive HBV labs or negative and positive HBV labs through the ELR. Also, how do you get total bilirubin results and ALT levels? Through the ELR or another means?

Thanks
Jennifer 

Comments & Events

Bill Storm Bill Storm
Ohio collects positive findings for Hep B from the following lab tests:

HBeAg
HBsAg
HBV DNA
IgM anti-HBc

We've had no success obtaining liver enzymes for *only* Hep tested patients. Every lab has had to either send them all or nothing and there is not really an easy way to link them to send in the same HL7 message. We are hopeful that electronic case reporting will allow those test results to finally be collected routinely when a hepatitis case report is triggered.

Thanks,
Bill
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Carmen Pugh, Labcorp Manager State Reporting at LabCorp Carmen Pugh, Labcorp Manager State Reporting
Labcorp can and will report any negative corresponding test and LFTs if required or requested by a state.  This means that we can report a negative HBeAg when reporting a positive HBsAg, as well as AST, ALT, or any other LFT required/requested, as long as the testing is performed on the same specimen number.  We are doing this type of reporting for most states.
Thanks,
Carmen
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David DiCesare David DiCesare
In NY we received negative Hep B DNA results. Positives only for all others.



Thanks.

David DiCesare
NYS ELR Coordinator
ECLRS Help Desk
Bureau of Surveillance and Data Systems
Local - 518-402-5943
Long Distance - 866-325-7743
David.dicesare@health.ny.gov
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Nancy Barrett, Epi 4/PH Informatics Specialist Nancy Barrett, Epi 4/PH Informatics Specialist
Hi, In CT the following HBV results are reportable:
1. IgM anti-HBc
2. HBeAg positives (electronic reporting only)
3. HBV DNA positives (electronic reporting only)
4. HBsAg (surface antigen) - Positives for everyone; negatives for children <= 2 yrs of age
5. anti-HBs (surface antibody) - all results but only for children <= 2 yrs of age

Nancy Barrett
nancy.l.barrett@ct.gov
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Annie Fine, CSTE Annie Fine
Hi Jennifer, I don’t know if anyone is on this site from NYC, but all HBV DNA tests (pos/neg/indeterminate) are reportable in NYC, as well as ALT collected on same specimen that was positive for any viral hepatitis (A,B or C). ALTs are definitely received -sometimes independently of the hep viral diagnostic tests - if no viral hep result is sent simultaneously or previously (in recent time) they are held until a hep result is sent for the same pt and sent in o the surveillance system if that happens.
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Michelle Miller, Informatics Michelle Miller, Informatics
For Washington our criteria is:
Positive results for:
  IgM anti-HBc,
  HBsAg,
  HBeAg, or
  HBV Nucleic acid detection (NAT or NAAT) either qualitative or quantitative, for example, PCR or genotyping.
If associated with a positive result listed above, and available:
  Hepatocellular enzyme levels, Pregnancy status, and Negative IgM anti-HBc result. 

The Pregnancy status is new to us this year, and the ELR onboarding team is working with the Hep SMEs to come up with ways to get the data they need, either with the ELR or in an alternative method.
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Ann Kayser Ann Kayser
For Minnesota:
Positive results for HBeAg, anti-HBc IgM; Positive HBsAg if no negative neutralization.  All HBV DNA, sensitivity, and genotype results. Most of this is through ELR.
For total bilirubin results and ALT levels, this is usually recorded during investigation (not collected via ELR)

Ann Kayser
ann.kayser@state.mn.us
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Deb Loniewski Deb Loniewski
In Michigan, we receive the following for HBV Labs:

Report all Positive/Reactive Labs for:
1)      HBV Surface Antigen (HBsAg)
2)      HBV e Antigen  (HBeAg) 
3)      HBV Core Antibody (anti-HBc IgM)
4)      HBV NAAT 
5)      HBV genotype
 
Plus, Report for Children ≤ 5 years of age:
1)      HBV Surface Antigen (HBsAg), positive, negative, indeterminate
2)      HBV Surface Antibody (anti-HBs), positive, negative, indeterminate


The above listing is going to change to ALL sometime in the future according to our Hepatitis B team, but today, that is what we onboard labs to report. Bilirubin, and LFTs will hopefully be sent in the eCR encounter messages to track treatment and monitoring.

Best regards,
Deb Loniewski
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Nicole Kikuchi Nicole Kikuchi
Florida requires all positive and negative HBV labs (all methodologies) as well as all ALT, AST, ALP and bilirubin results to be reported by health care providers and laboratories in the presence of any positive Hepatitis B, C, D, E or G lab result. If a laboratory is participating in ELR, all these items are expected to be reported through ELR.

Nicole Kikuchi, MPH, CPM
Surveillance/Informatics Epidemiologist
Bureau of Epidemiology │ Division of Disease Control and Health Protection │ Florida Department of Health
Mobile: 850-251-5786 │ Fax: 850-922-9299 │ Confidential Fax: 850-414-6894 │ Email: Nicole.Kikuchi@flhealth.gov<mailto:Nicole.Kikuchi@flhealth.gov>

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