Lab Result Reporting

Hospital laboratories and reference laboratories that perform or order tests for reportable conditions under the diseases rule and COVID-19 testing sites need to report results to the Health Department. COVID-19 testing sites are defined as:

• laboratories that perform clinical diagnostic or screening testing under CLIA,
• non-laboratory COVID-19 diagnostic or screening testing locations, and
• other facilities or locations offering COVID-19 point-of-care diagnostic or screening tests, such as employers, and
• other facilities or locations offering in-home diagnostic or screening tests.

NOTE: For labs performing COVID-19 testing, please jump to SARS-CoV-2 Reporting Requirements.

The Health Department accepts HL7 2.5.1 messages from facilities reporting reportable laboratory findings. For laboratories seeking to connect to Vermont, please email AHS.VDHELRSupport@vermont.gov.

If your facility performs only COVID-19 testing, please see the SARS-CoV-2 Specific Requirements.

While working towards electronic reporting, fax all positive results to 802-951-4061 within 24 hours, unless otherwise instructed.

Hospitals should follow any Promoting Interoperability Program requirements. Electronic lab reporting (ELR) is a Core Item for Meaningful Use Stage 3. Vermont can receive ELR from Eligible Hospitals as HL7 ORU v2.5.1 messages. 

Note to hospitals performing in-house reportable disease testing: Please email AHS.VDHELRSupport@vermont.gov to confirm your electronic reporting status. All positive results should be faxed, unless confirmation has been made that we are receiving in-house results through an electronic feed.

All COVID-19 results (positive, negative, etc.) are required to be reported to the Vermont Department of Health within 24 hours of test report completion, including:

• All types of testing (PCR, antigen, point-of-care tests, antibody)
• Vermont residents
• Tests collected in Vermont
• Tests ordered by providers or facilities in Vermont

Examples of results that needs to be reported:

• Patients with home addresses in Vermont
• Patients who reside in other states and were tested in Vermont
• Patients with Vermont ordering providers
• Patients utilizing Vermont health care services or attending school in Vermont

The COVID-19 testing site is responsible for sending results to the Health Department. If you have an established feed with the Health Department, these results should be included in your existing HL7 ELR message. If you have no established feed, the following are options for electronic reporting:

• HL7 2.5.1 message
• Automated spreadsheet using the National Flat File schema
• State of Vermont - COVID-19 Test Result Reporting Form
• National Healthcare Safety Network (NHSN) Point-of-Care Test Reporting Tool (preferred method for CMS-certified long-term care facilities)
• Centralized ELR Option through APHL AIMS Platform

The Health Department will report all COVID-19 results received electronically to the U.S. Department of Health and Human Services (HHS) on behalf of all facilities reporting to Vermont.

Until your facility is onboarded to report electronically, please fax any positive test result to 802-951-4061 within 24 hours. The faxed report should include patient demographic information (name, date of birth, contact information), test type and result, and reporting facility information (name and contact information). Facilities may choose to use the weekly lab report form.

Note to hospitals performing in-house COVID-19 testing: Please email AHS.VDHELRSupport@vermont.gov to confirm your electronic reporting status. All positive results should be faxed, unless confirmation has been made that we are receiving in-house results through an electronic feed.

All COVID-19 test results (including positive and negative results) are required to be reported to the Health Department within 24 hours of receiving the test result. Timely reporting of positive COVID-19 test results is especially critical to protect public health.

If your business or organization is doing COVID-19 testing through an employee health provider, reference laboratory, or similar medical facility, please work with them to make sure they are reporting results for your organization to the Health Department.

If your business or organization is performing COVID-19 testing and not working with an employee health or similar provider, your organization will need to report these test results directly to the Health Department. The Health Department has several reporting options. Review the chart below to determine the best fit for your organization.

Please reach out to the Health Department at AHS.VDHLabReportFormSupport@vermont.gov with any questions about COVID-19 test result reporting options or requirements.

Vermont Department of Health is partnering with the Vermont Health Information Exchange (VITL) to enable COVID-19 testing sites reporting only COVID-19 test results to report electronically. Laboratories are prioritized for onboarding based on volume. VITL is able to onboard HL7 electronic lab reporting (the preferred method) or an automated flat file adhering to the National Flat File schema through SFTP or VPN connections.

To request this method of electronic submittal of COVID-19 testing results, please complete this ELR Request form and have the following information accessible:

Organization, Contact Name, and Contact Email Address
The contact should be someone at the facility who will be able to interact with our technical staff to develop the messages and who has the capacity to respond quickly to requests for information.

Type(s) of testing performed (you may select multiple)
PCR, antigen, serology (antibody), home test kit, other.

Message type
Select HL7 if your facility is capable of producing an HL7 message.
Select Flat File if you will be utilizing the CSV format.

Third-party vendor for your lab software, if applicable

Approximate volume per week of Vermont residents tested

There are several reporting options for COVID-19 testing sites conducting point-of-care testing without the capability to report via HL7 message or automated flat file. This may include clinicians, health care facilities, and other settings using point-of-care testing.

1. For CMS-Certified Nursing Facilities performing point-of-care testing, the National Healthcare Safety Network (NHSN) Point-of-Care Test Reporting Tool is the preferred method for reporting of all results from point-of-care COVID-19 tests within 24 hours. NHSN will report to the Health Department, which will fulfill your requirements for reporting as a COVID-19 testing site to the state. To utilize this pathway, facilities need to update their NHSN Secure Access Management Service (SAMS) credentials from Level 1 to Level 3. The upgrade process can take up to four weeks. Training on the use of this pathway was released by the CDC in October 2020. Nursing homes that are still working through the process of updating to Level 3 credentials should report to the Health Department through one of the other channels described her.
2. SimpleReport: SimpleReport was developed in partnership with the CDC and is a free tool that makes it easy for COVID-19 testing sites to record results. It works with any rapid point-of-care test so you can quickly report data to public health departments. This tool is a good fit for facilities who may be doing repeat testing for the same patients (residents, employees, students, etc.), and/or facilities who would benefit from the built-in workflow and data management SimpleReport provides. Please plan to utilize an alternate reporting method (such as the State of Vermont Test Result Reporting Tool or fax) until we are able to verify the results are being reported through SimpleReport.
3. NAVICA app for Abbott BinaxNOW Testing: If you are conducting point-of-care testing utilizing Abbott BinaxNOW antigen test cards, the NAVICA app can be used to report results to the Health Department. The NAVICA system features easy-to-use apps for the person being tested and the COVID-19 testing site, and includes state reporting capabilities through the NAVICA Connect Portal. Please plan to utilize an alternate reporting method (such as the State of Vermont Test Result Reporting Tool or fax) until we are able to verify the results are being reported through NAVICA.
4. The State of Vermont – COVID-19 Test Result Reporting Form is an online web-entry form. This tool is a good fit for facilities with a low volume of results to report to the health department. The form is also very quick and easy to onboard, making it a good interim reporting solution for facilities who plan to utilize other electronic reporting solutions with longer onboarding times.
   • Register your facility for online reporting. Your facility will not be able to submit result data through the reporting form without registering first.
   • Once the facility has been registered, you will receive the link to the reporting form and a unique username and password for your facility within 2-3 business days. This allows us to prepopulate facility-specific information in the back end to help your facility more easily enter result data.

Questions? Contact ahs.vdhlabreportformsupport@vermont.gov 

Health and Human Services has additional data requirements for COVID-19 test results, including patient demographic information (age, race, ethnicity, sex) and the following seven “ask on order entry” (AOE) questions.

1. Is this the patient’s first test? (Y/N/U)
2. Is the patient employed in healthcare? (Y/N/U)
3. Is the patient symptomatic as defined by CDC? (Y/N/U)
4. If yes, then Date of Symptom Onset (mm/dd/yy)
5. Is the patient hospitalized? (Y/N/U)
6. Is the patient hospitalized in the ICU? (Y/N/U)
7. Is the patient a resident in a congregate care setting? (Y/N/U)
8. Includes nursing homes, residential care for people with disabilities, psychiatric treatment facilities, group homes, board and care homes, homes shelters, foster care, etc.
9. Is the patient pregnant? (Y/N/U)

If you are reporting via HL7 message or the National Flat File schema, Vermont can accept properly formatted AOE questions. HHS has published guidance for HL7 specifications.

The Health Department prefers to receive whole genome sequencing information as an electronic lab report using a facility’s existing connection. Please refer to the CDC guidance for formatting this information: https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/reporting-sequencing-guidance.html and reach out to ahs.vdhelrsupport@vermont.gov to submit test messages for review prior to including this information in your production feed.

The Association of Public Health Laboratories (APHL) has a centralized ELR service, APHL Informatics Messaging System (AIMS), that routes messages to individual public health jurisdictions using a single connection to AIMS, rather than a lab needing individual connections with each state.

If your facility is reporting to multiple states, this may be a better option for COVID-19 reporting.