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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 Doug York ·

Lab Developed Test Information

Greetings,
 
We are preparing to onboard Sonic Healthcare USA to our Expanded ELR solution. In looking over Sonic’s test compendium, they appear to have some lab developed multiplex tests that do not have LOINC (or PLT) codes for OBR-4 (Universal Service Identifier). Their tests do (mostly) have valid LOINC codes for OBX-3 (Observation Identifier) and we will be working with Sonic to determine if PLT codes and LOINC codes are needed for those that do not. Would your jurisdiction be willing to accept a local code in OBR-4 provided that there are valid LOINC or PLT codes for each OBX-3, or would you prefer a standardized code (LOINC or PLT) in OBR-4? 

Comments & Events

Sita Smith Sita Smith
MA could accept local codes, we would do our own mapping internally. We'd love to see some test messages, though!
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Robb Byres Robb Byres
Idaho can accept local codes in OBR.4

Thank You

Robb
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Ann Kayser Ann Kayser
For OBR.4 - MN can accept local codes, but we push to place them in the second/alternate triplet (i.e. OBR.4: |^^^CL2^Culture test^L|) as opposed to the first.
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Mark Dittman Mark Dittman
PA will not accept local codes in the first three positions, but will accept them as Ann noted below... we require LOINC and SNOMED in the OBX segment. We did not have major issues with Sonic when we onboarded them.
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Corinne Davis, HL7 Implementation SME Corinne Davis, HL7 Implementation SME
NH can accept local codes in OBR-4 and they need to be in the second triplet. We need LOINC and SNOMED in the OBX segments. 

We also need to see a vocab sheet/test compendium (LOINC, SNOMED) for all the tests that will be sent through prior to approval for go live. This allows us to map the testing in our system so messages will not be rejected.
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Denise Ok Denise Ok
Hawaii can accept local codes in OBR-4 provided that there are valid LOINC or PLT codes for each OBX-3. 
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Teri Bills Teri Bills
UT can accept local codes if the descriptions are detailed enough that we understand test types and what they're testing for.
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Jennifer Floch Jennifer Floch
When onboarding new facilities, MT no longer accepts local codes in OBR-4. MT no longer accepts local codes to comply with grant requirements and for standardization purposes. 
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Nancy Barrett, Epi 4/PH Informatics Specialist Nancy Barrett, Epi 4/PH Informatics Specialist
CT does not rely on the OBR-4, but we'd prefer Sonic to use proper codes. We are not going to translate local codes. We absolutely require LOINC and SNOMED in OBX.3 and OBX.5 with a proper datatype. Also, if they are reporting NM or SN results, we won't process those if a ST or TX datatype is used. The numeric results also have to be properly structured in OBX.5 for a SN. If a PLT code is going to be used, we'd like to know that ahead of time. And test messages are a must! :-)

And don't forget SNOMED codes for the specimen source/types!

Thanks. 
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Doug York, Specialist, Terminologist Datapult at Association of Public Health Laboratories Doug York, Specialist, Terminologist Datapult
Thank you everyone for your responses. We have noted your responses and will proceed accordingly. 

As an update, we will be having the kickoff on 10/4. One thing to be aware of is that we will be onboarding Sonic Reference Laboratory first, and then add other labs at Sonic's determination. We will be working closely with the jurisdictions that will receive results, including sending the test compendium and test messages.
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Joyce Boyd-Lee Joyce Boyd-Lee
Upon review with NJDOH ELR Team, testing the OBR-4 field is an acceptable testing field. From a technical standpoint, please be sure the field is formatted correctly.

Should you have any questions, please notify.

Respectfully,

Joyce Boyd-Lee
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RJ Kelly, ELR/eCR Specialist RJ Kelly, ELR/eCR Specialist
North Carolina does not rely on the OBR-4, but we'd prefer Sonic to use proper coding practices. LOINC/SNOMED in the first triplet, local codes in the second triplet or fill in the "OriginalText" field.
 
LOINC and SNOMED are required in all OBX segments, i.e.  OBX.3 and OBX.5 with a proper datatype. 
If a PLT code is going to be used, we'd like to know that ahead of time. And test messages are a must! :-)

And don't forget SNOMED codes for the specimen source/types! 

Thank you Nancy :) 
RJ Kelly 
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Asenath Onderi, HL7 Analyst at Texas Department of State Health Services Asenath Onderi, HL7 Analyst
For TX we require standardized LOINC/PLT codes to be populated in OBR 4.1-4.3 , If they chose to use local codes that’s acceptable but they must be populated in the correct component OBR 4.4-4.6 
 
For OBX-3, LOINC codes/PLT codes are required in OBX 3.1-3.3. If they use PLT codes, we need the test catalog to map in Rhapsody. 
 
We prefer to receive test messages whenever Sonic is ready to begin testing. 

Thank you,
Asenath 
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Swathi Ramasahayam Swathi Ramasahayam
Iowa can accept local codes, but we prefer standard codes if that an option in OBR.4. OBX-3 and OBX-5 must be strictly LOINC and SNOMED Codes. PLT codes in OBX-3 are acceptable only when the LOINC Code for that test is not available.
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Cody McNeese Cody McNeese
Oregon would prefer to receive standardized codes in OBR-4 (LOINC or PLT). We are moving away from the acceptance of local codes and are trying to transition everyone to the use of standardized code sets. 
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Michael Nuss, Informatician at Nebraska Department of Health and Human Services Michael Nuss, Informatician
Nebraska would prefer to receive standardized codes in OBR-4 (LOINC)
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