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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 Kristy Lunquest ·

Reporting results for Out of State (OOS) residents

Hi all,

I understand each state may have their own reporting regulations, but I wanted to hear from others about this situation:

One of our epidemiologists here at the MD Dept of Health found a couple results that were reported by the in-state facility, but not by Quest. The patient addresses for those two results are OOS and Quest told us that they report based on patient address (and if no address, they would default to facility address). Here in MD, we would expect the OOS lab (Quest) to report to us if the originating facility is in state, which it is.  

Have others had issues with this? Is this more commonly seen with commercial labs?

Thanks!

Comments & Events

Sarina Leete Sarina Leete
Good morning Kristy - 

ARUP here. We follow the same logic as Quest. The "ordering facility" state in our system may not be the true "originating facility" state, especially if it has passed through multiple labs before being delivered to us. 

Thanks!
Sarina
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Zana Stephenson Zana Stephenson
Hi Kristy!

Here in Missouri, we do not want lab reports for patients who are residents of another state, even if seen by a Missouri provider. 

Thanks!
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Annie Fine Annie Fine
In NYC and NYS, labs are required to report to our ELR system solely based on the residence of the patient. That said, many hospitals and labs do report patients who do not reside in NYS or NYC.  If pt address is available, reports are routed to the jurisdiction of residence. If pt address is not available, reports are routed to the jurisdiction where the provider resides or where care was provided (the facility). 

I am wondering from the commercial or reference labs on this site how often they actually do have patient address available, especially in situations where the specimen has made more than one hop. I know missing patient address has been a problem in the past. What do you do - where do you sent the report if patient address is unavailable?  Thank you!
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Kristy Lunquest, Maryland Department of Health Kristy Lunquest
Hi Annie,

I know when the patient address is not available for Quest, they report to the state of the originating hospital/facility. That is what I was told yesterday after asking about this.
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Logan Smith Logan Smith
In Virginia, our reporting regs say that labs located in the state must report to the state. That means we receive reports on VA residents and non-VA residents. Since the regs are specific for labs actually located in the state, any reference lab not actually located here would not be mandated to report to us. There is a Quest facility located in Virginia and they report to us as per state reporting regs, but other Quest (QLS) labs send ELR to us based on the patient's address or if no address, the ordering facility address. Any out of state patient reports we receive have to be transferred to the appropriate state. (This is a plug for interstate messaging!)
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Nancy Barrett, Epi 4/PH Informatics Specialist Nancy Barrett, Epi 4/PH Informatics Specialist
Hi Kristy, I believe that issue is more common when a test is ordered from a commercial lab. Many of commercial have labs have said that if there is no patient address, they will send results to the state of the orderer. And yes, I think we are all aware of the issue of loss of information as a specimen is passed along to the final testing lab. In CT, hospitals, especially smaller facilities, are doing fewer tests at the hospital lab and sending for testing to a variety of commercial/clinical labs.

CT requires in-state labs to report what they find even if person tested is from out of state. We filter out in our ELR system the OOS based on program needs. Manual entry does the same. Commercial labs must also report under our regulations, but we expect they will send us only CT residents. We have seen from Quest QLS some instances with blank patient addresses with an ordering provider from another state that we've asked Quest to not send. BTW, we are "dual" reporting state -- both the ordering lab and the testing labs must report.
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Nancy Barrett, Epi 4/PH Informatics Specialist Nancy Barrett, Epi 4/PH Informatics Specialist
Hi Kristy -- is it okay with you if we put this on the agenda for tomorrow's ELR call?
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Kristy Lunquest, Maryland Department of Health Kristy Lunquest
Hi Nancy. Sure, you can do that.
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Nancy Barrett, Epi 4/PH Informatics Specialist Nancy Barrett, Epi 4/PH Informatics Specialist
Thanks!
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