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.

Information for Laboratories Reporting COVID-19 Test Results

See the latest Health Update: April 6, 2020 Update: Reporting COVID-19 Cases
https://health.mo.gov/emergencies/ert/alertsadvisories/pdf/update4620.pdf

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.

Methods of Reporting Laboratory COVID-19 Test Results

Laboratories are encouraged to report via electronic means.

  • Submitting spreadsheets to BRDI by secure file transfer protocol (sFTP)
    • Please call 573-526-5271. The sFTP option functions as a secure online folder where files may be submitted with no wait. In order to use this option, at least one contact e-mail address for the submitting organization must be provided. Further instructions will be sent to the indicated e-mail address(es) once an account is set up for the organization.
    • Format:
      • Laboratories may use their own format OR
      • Laboratories may use our template.
      • Submit individual laboratory reports in portable document format (PDF) files sent to BRDI by secure file transfer protocol (sFTP)
  • Alternatively, laboratories may submit via fax to BRDI at 573-751-6417. Please note that this fax line experiences high volume during normal business hours.

In the future, BRDI will work to onboard laboratories who wish to submit electronic laboratory reports (ELR) via Health Level Seven (HL7) messages. ELR HL7 onboarding is currently suspended due to COVID-19.

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
  • sex
  • race
  • ethnicity

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.

Disease Case Report Reporting from Medical Providers

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 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. See https://health.mo.gov/living/healthcondiseases/communicable/communicabledisease/index.php for disease case reporting information.

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.
https://www.sos.mo.gov/CMSImages/AdRules/main/suspensionofrule/19c20-20.020IIA.pdf

Commentary from BRDI

Some local public health authorities require laboratories to report laboratory results – the waiver does not prohibit reporting to local public health authorities but it does mandate laboratories must report to DHSS.

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.

https://www.sos.mo.gov/CMSImages/AdRules/main/suspensionofrule/19c20-20.020IA6.pdf