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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 Riki Merrick ·

Question about changing ELR R1 handling reports of specimen collection date, when unknown

All,
I got this question from Quest:
Several departments of health have asked us to not report “0000” in the OBR-7, OBX-14 and SPM-17 fields when we don’t have a specimen collection date and time to report. Because these fields are required in the first and last fields, leaving the fields blank isn’t a valid option since such messages would likely fail the validation process on the AIMS Platform and will not be delivered. 

ELR R1 follows HL7 guidance on use of '0000' when dates are unknown - which is the most "honest" report.
Wouldn't it be safer to know the date was unknown and make the determination of using a different date - for example the specimen received date instead at the PHA, rather than having a valid date provided, and not knowing, or having to read that in a NTE?

Riki

Comments & Events

Sita Smith Sita Smith
In MA we've had an ongoing issue with Quest and missing specimen collection date. These messages fail in the in our portal; in the past we have called ordering providers for the specimen collection date, but post-Covid that is impossible because of the sheer scale. Our work around now is to copy result date into the specimen collection date field and add a note to that effect. I am uncomfortable with this but see no option. About 5-10% of Quest records are missing specimen collection date, which is a significant worry because it's such an important date from the surveillance perspective. Rather than finding ways to consume these message, I would suggest that 
Quest mandate that providers supply it .
How in the world are we ever going to be able to collect AOE variables if Quest cannot consistently supply something as basic and important as collection date? We do not have a problem collecting collection date from a single other provider -  and that includes point of care.
Kristy Lunquest, Maryland Department of Health 👍
Notified 148 people
Walter Kemper, ELR Coordinator, NC DHHS Div of Public Health Walter Kemper, ELR Coordinator, NC DHHS Div of Public Health
We would not want a fake date.

But I agree that it would be desirable that Quest influence its customers to supply the collection date. 
Notified 148 people
Nancy Barrett, Epi 4/PH Informatics Specialist Nancy Barrett, Epi 4/PH Informatics Specialist
Hi, we have the same issue with Quest (and missing specimen type) - but specimen collection date is a big issue. It looks like it test requests from FQHC and providers, but we also do not have time to track this down. It should be a required entry on their interfaces -- I've made this request to Quest before. 

Also, every state should be able to handle the HL7 2.5.1 messages including date-time stamps. I think we need to stop having labs taylor a known and accepted message format for each state.

Along those lines -- I'd like to be able to have labs switch to HL7 2.5.1 instead of using 2.3.1 which is very much not desirable.
Notified 148 people