Laboratory Reporting of COVID-19 Test Results
The Bureau of Reportable Disease Informatics (BRDI) focuses on data collection, management, reporting and analysis related to more than 90 reportable communicable (or infectious) diseases, sexually transmitted infections (STIs) and zoonotic diseases. BRDI maintains a statewide surveillance system (WebSurv), manages the enhanced HIV/AIDS Reporting System (eHARS) for HIV incidence and prevalence, and performs analysis of morbidity to identify geographic and demographic trends and risk factors.
EpiTrax is a comprehensive disease surveillance system that receives laboratory reports for COVID-19 tests. EpiTrax is the authoritative record to trigger case management and investigations. While EpiTrax currently only houses COVID-19 data, all other disease and condition data will be migrated to EpiTrax in subsequent projects.
Reporting Laboratory COVID-19 Test Results
Laboratories are encouraged to report via electronic means.
Secure File Transfer Protocol (SFTP) reporting is the preferred method to electronically report COVID-19 laboratory results. The Onboarding Team will reach out with more information and instructions. Messages must be placed in the DHSS formatted template.
If reporters are not able to report results electronically, contact the Bureau of Reportable Disease Informatics at 573-526-5271 to establish an alternative reporting plan.
DHSS is not currently onboarding ELR HL7 providers outside of those reporting COVID-19 results.
Required Data Elements
Per state regulation, 19 CSR 20-20.80, laboratories shall report “[…] the test performed, all results of the test, including numeric results, if applicable, units of measure of the results, and reference ranges for normal and abnormal results, the name and address of the attending physician, the name of the disease or condition diagnosed or suspected, the date the test results were obtained, the name and home address (with zip code) of the patient and the patient’s age, date of birth, sex, race, and ethnicity.”
Laboratories should note their obligation to report:
- home address (with zip code)
- date of birth
- phone number
It is the responsibility of the laboratory to assure this information is provided. This may require laboratories to work with a patient’s physician (or other health care provider) ordering the laboratory test to be performed.
Electronic COVID-19 Case Reporting
Per state regulation, 19 CSR 20-20.020 (6), medical providers (non-laboratories) also have an obligation to submit disease case reports (form CD-1) to DHSS. However, under the current suspension, providers do not have to report negative results if those results are being reported by an outside lab. Providers are expected to submit a case report on any non-negative results as the additional information on the case report is required for public health intervention.
To report COVID-19 cases electronically, visit the Electronic COVID-19 Case Reporting System homepage to access the system and learn more from the user guide and FAQs. Medical providers who had already established case reporting via spreadsheet with the Bureau of Reportable Disease Informatics prior to the development of the electronic CD-1 portal should continue to submit via spreadsheet.
COVID-19 Emergency Amendment and Waivers of Administrative Rules Basics
DHSS filed an emergency amendment of 19 CSR 20-20.020, which added COVID-19 to the list of immediately reportable conditions, with the Missouri Secretary of State on January 27, 2020. It became effective on February 10, 2020 and was published in the March 2, 2020 edition of the Missouri Register (https://www.sos.mo.gov/CMSImages/AdRules/moreg/2020/v45n5Mar2/v45n5a.pdf). Additionally, on March 21, 2020, DHSS waived a few provisions of 19 CSR 20-20.020 in order to require that all positive and negative results for COVID-19 are sent directly to DHSS. Now, all laboratories must report directly to DHSS. Prior to the waiver of these rule provisions, laboratories could choose to report to DHSS or the local public health authority. Some jurisdictions may have standing legal requirements that laboratories must report directly to local public health authorities. The DHSS waiver does not prohibit additional reporting to local public health authorities, it merely requires laboratories to report directly to DHSS.
COVID-19 Waivers of Administrative Rules
Requirement to Report COVID-19 Directly to DHSS
19 CSR 20-20.020 (1), (6), and (8) shall be waived to the extent necessary to have all positive and negative test results for COVID-19, be sent only to the Department of Health and Senior Services. This waiver will remove the option for the reporter to send such result to either the local health authority or the Department of Health and Senior Services.
Duplicate Reporting by Hospital and External Lab
19 CSR 20-20.020(6) shall be waived to the extent that it requires duplicative reporting to the Department of Health and Senior Services of negative test results for 2019 Novel Coronavirus (2019- nCoV) by a hospital and the separate laboratory that conducted the testing. Under this waiver, when the testing is conducted outside the hospital by a separate laboratory that must also report the result to the Department, only the laboratory must make the report.