Section 173-1-005 - METHODS OF REPORTING005.01 Healthcare Providers 1-005.01AImmediate Reports of Diseases, Poisonings and Organisms: Healthcare providers must report diseases, poisonings and organisms, listed in 173 NAC 1-004.01A, by telephone, facsimile or other secure electronic mail system within 24 hours of diagnosis or detection. Reports must include the information as specified in 1-005.01D. See 173 NAC 1-006, Where to Report. 1-005.01BImmediate Reports of Clusters, Outbreaks, or Unusual Events, Including Possible Bioterroristic Attacks: Healthcare providers must report by telephone, facsimile, or other secure electronic mail system, information relating to confirmed, diagnosed, detected, or suspected clusters, outbreaks, or epidemics of any health problem, infectious or other, both in the community and in healthcare settings, including food poisoning, influenza or possible bioterroristic attack; increased disease incidence beyond expectations; unexplained deaths possibly due to infectious causes; any unusual disease or manifestations of illness. Reports must include the information as specified in 1-005.01D. See 173 NAC 1-006, Where to Report.1-005.01CReports Within Seven Days: Healthcare providers must make reports of diseases, poisonings and organisms listed in 173 NAC 1-004.02, within seven days of diagnosis or detection. 1-005.01C1Reports may be made by postal service, telephone, facsimile, electronic laboratory report, or other secure electronic mail system and must include the information as specified in 1-005.01D.1-005.01C2 AIDS and HIV disease reports may be made by postal service, telephone, facsimile , electronic laboratory report, or other secure electronic mail system, submitted on or including the same information as Attachment A. Adult cases of AIDS and HIV disease (patients > 13 years of age at time of diagnosis) must be submitted on or include the same information in the Adult HIV Confidential Case Report Form as described in 173 NAC 1-002. Pediatric cases of AIDS and HIV disease (patients < 13 years of age at time of diagnosis) and perinatally exposed HIV cases must be submitted on or include the same information in the Pediatric HIV Confidential Case Report Form, described in 173 NAC 1-002. AIDS and HIV case reports are required from healthcare providers responsible for:
1. Treating or diagnosing a person with HIV-1 or HIV-2 disease, based on the laboratory tests listed in 173 NAC 1-005.02B3a1 as being definitive for HIV infection, or based on clinical criteria, as outlined in the CDC's most recent case definition for HIV;2. Treating or diagnosing a person with AIDS as outlined in CDC's most recent case definition for AIDS;3. Providing medical care to a pregnant woman with HIV disease;4. Providing medical care to a baby under 19 months of age born to a woman with HIV disease (perinatally HIV exposed). The diagnosis of HIV infection or determination of no infection is determined by CDC's most recent case definition for HIV; and5. Treating or diagnosing potential cases of public health importance related to HIV infection including: a. Unusual strains of HIV (HIV-2 or non-B subtype of HIV-1); andb. Unusual modes of transmission (such as, but not limited to transplant or artificial insemination; transfusion of blood or blood components, child sexual abuse, occupational, household, or other unusual exposure). 1-005.01C3Reporting of Tuberculosis: Healthcare providers must report positive tuberculosis diagnostic tests (culture and nucleic acid amplification) or positive histological evidence indicative of tuberculosis infection or disease.1-005.01D Report Information: Reports made under 1-005.01 must contain the following information:1.Patient first and last name;2.Patient address including street, city, and zip;5.Patient race and ethnicity (if available);6.Patient occupation (if available);7.Patient pregnancy status (if available);10.Physician address and telephone number;11.Name of hospital or clinic (if any)12.Date and time of onset (if available);13.Date of diagnosis (if available);14.Mode of transmission (if available);15.Date of specimen collection;17.If lead test, whether sample is a capillary or venous blood sample;19.Laboratory findings or result;20.Other information pertinent to the case as requested.1-005.01EReporting to Laboratories: For all laboratory tests which may identify a reportable disease (e.g. microbiology tests, hepatitis tests, etc.) and which are ordered through submission of an electronic requisition or other automated electronic mechanism, providers must include the information as specified in 173 NAC 1-005.02B4 (except laboratory findings or result) at the time the test order is placed to the laboratory so that the laboratory may fulfill reporting requirements .005.02 Laboratories 1-005.02AElectronic Reporting:All laboratories performing clinical testing on Nebraska residents must electronically report laboratory test results for the diseases specified in 173 NAC 1-004 and the tests specified in 1-005.02. This may be accomplished either through manual online data entry into Nebraska's electronic disease reporting system, or through automated electronic laboratory reporting. Paper reports will be accepted only when established electronic transmission methods are inoperable.1-005.02BLaboratories Using NEDSS Manual Online Reporting1-005.02B1Immediate Reports of Diseases, Poisonings, and Organisms: Laboratories must make immediate reports of diseases, poisonings, and organisms listed in 173 NAC 1-004.01A, both by telephone to a live public health surveillance official within 24 hours of diagnosis or detection and by electronic reporting to NEDSS. Reports must include the information as specified in 1-005.02B4. See 173 NAC 1-006, Where to Report. 1-005.02B2Immediate Reports of Clusters, Outbreaks, or Unusual Events, Including Possible Bioterroristic Attacks: Laboratories must make immediate reports by telephone to a live public health surveillance official within 24 hours of diagnosis or detection, information relating to diagnosed, detected, or suspected clusters, outbreaks, or epidemics of any health problem, infectious or other, both in the community and in healthcare settings, including food poisoning, influenza, or possible bioterroristic attack; increased disease incidence beyond expectations; unexplained deaths possibly due to infectious causes; and any unusual disease or manifestations of illness. Reports must include the information as specified in 1-005.02B4.1-005.02B3Reports Within Seven Days: Laboratories must make reports of diseases, poisonings, and organisms diagnosed or detected, listed in 173 NAC 1-004.02, collected during one calendar week. Reports must be submitted no later than the following Tuesday and must include the information as specified in 1-005.02B4.1-005.02B3a For the purposes of reporting AIDS and HIV, the laboratory reporting requirement applies as follows: 1. Any FDA approved test or combination of tests indicative of HIV-1 or HIV-2 that has acceptable specificity and sensitivity to reliably detect HIV infection is reportable.2. A laboratory analyzing samples for any of the tests as listed below must report all of the following results: a. Any result (positive, negative or indeterminate) on a confirmatory test for HIV antibody , (e.g. Western blot or immunofluorescence antibody test ), usually preceded by a positive screening test for HIV antibody, (e.g. repeatedly reactive enzyme immunoassay);b. All quantitative HIV RNA PCR tests regardless of the result. Include the detailed name of the test, detection limits of test, and/or interpretation of results. (This applies only to laboratories performing ELR.); c. All positive results on any of the following: (1) Qualitative HIV nucleic acid (DNA or RNA) detection [e.g. DNA polymerase chain reaction ];(2) HIV p24 antigen test, including neutralization assay;(3) HIV isolation (viral culture); andd. All CD4 counts per microliter and all CD4 percentages. 1-005.02B4 Report Information: Reports made under 1-005.02B must contain the following information:1.Patient first and last name;2.Patient address including street, city, and zip;5.Patient race and ethnicity (if available);6.Patient pregnancy status (if available);7.Date of specimen collection;9.If lead test, whether sample is a capillary or venous blood sample;11.Laboratory findings or result;13.Physician address and telephone number.1-005.02CLaboratories Using Automated Electronic Laboratory Reporting (ELR)1-005.02C1 Required data fields include: 1. Patient first and last name;2. Patient address including street, city, state, and zip;3. Patient date of birth;6. Performing laboratory's name, address, and phone number;7. Date and time of specimen collection;8. Date and time the test was performed;10. Type of test performed;13. Date and time the test was verified;16. Submitting provider's name, address, phone number, and office name; and, if available,18. Race/Ethnicity (Hispanic / Non-Hispanic);19. Code for ordered test;20. Code for test result;22. High and low result reference range;24. Provider office ID number;26. The following data elements stored in the PV1 segment of HL7: Element Name | Sequence |
Patient Class | 2 |
Assigned Patient Location | 3 |
Admission Type | 4 |
Prior Patient Location | 6 |
Attending Doctor | 7 |
Admit Source | 14 |
Admitting Doctor | 17 |
Patient Type | 18 |
Discharge Disposition | 36 |
Discharged to Location | 37 |
Admit Date and Time | 44 |
Discharge Date and Time | 45 |
A laboratory's test results must be screened via an automated computer algorithm no less than once every 24 hours, and a file or files meeting this reporting requirement must be forwarded electronically to the department no less than once every 24 hours. Automated computer screening algorithms must be validated initially and once each year to ensure the screening process will capture all reportable disease test results that may be generated by the reporting laboratory. Results of this validation must be documented and maintained on file for two years at the laboratory for review by the department.
Electronic reporting does not exempt the laboratory from reporting by telephone those diseases that must be reported immediately.
1-005.02C2 Reporting of Antibiotic Susceptibility Results: Laboratories with automated electronic reporting capability which perform antibiotic susceptibility testing (AST) for bacterial diseases listed under 173 NAC 1-004 must report antibiotic susceptibility results, including minimal inhibitory concentration, for these tests. This requirement includes traditional broth, agar, and newer automated methods of AST, as well as molecular-based methods that assay for the molecular determinants of antibiotic resistance. Reports must include the method used for AST. Clinical laboratories must report AST results to the DHHS Division of Public Health via automated ELR. When necessary for the protection of the public health, the DHHS Division of Public Health may request additional reporting of AST results on other infectious agents that have increased in either incidence or severity.005.03 Healthcare Associated Infections HAI reports made to NHSN need not be reported separately to state and local public health departments provided access to NHSN HAI data has been given to state and local public health departments.
173 Neb. Admin. Code, ch. 1, § 005