R386-702-7. Required Information

  (1) Entities shall include as much of the following information as is known when reporting events specified in Subsections R386-702-3(2) through R386-702-3(6) to public health:

  (a) Patient information:

  (i) Full name;

  (ii) Date of birth;

  (iii) Address, including street address, city, state, and zip code;

  (iv) Telephone number;

  (v) Gender;

  (vi) Race and ethnicity;

  (vii) Date of onset;

  (viii) Hospitalization status and date of admission; and

  (ix) Pregnancy status and estimated due date.

  (b) Diagnostic information:

  (i) Name of the diagnostic facility;

  (ii) Address, including street address, city, state, and zip code; of the diagnostic facility;

  (iii) Telephone number of the diagnostic facility;

  (iv) Full name of the ordering or diagnosing health care provider;

  (v) Address, including street address, city, state, and zip code; of the ordering or diagnosing health care provider; and

  (vi) Telephone number of the ordering or diagnosing health care provider.

  (c) Reporter information:

  (i) Full name of the person reporting;

  (ii) Name of the facility reporting; and

  (iii) Telephone number of the person or facility reporting.

  (d) Laboratory testing information:

  (i) Name of the laboratory performing the test;

  (ii) The laboratory's name for, or description of, the test;

  (iii) Specimen source;

  (iv) Specimen collection date;

  (v) Testing results;

  (vi) Test reference range; and

  (vii) Test status (e.g. preliminary, final, amended and/or corrected).

  (2) Entities shall submit reports that are clearly legible and do not contain any internal codes or abbreviations to the Department.

  (3) Entities submitting or forwarding a specimen for testing using a laboratory test identified in the Utah Electronic Laboratory Reporting Specifications for Communicable Diseases shall include the patient's address, so that the performing laboratory can report results to the appropriate public health agency.

  (a) If the patient's address is not known by the submitting or forwarding entity, the submitting or forwarding entity shall provide the performing laboratory with the name and address of the facility where the specimen originated.

  (4) Entities shall reference http://health.utah.gov/epi/reporting, or contact the Department at [phone], for additional reporting specifications, including technical documents, reporting forms, and protocols.

  (5) Full reporting of all relevant patient information is authorized when reporting events listed in Subsection R386-702-3(8) to public health.

  (a) Entities shall include in reports at least the following information, if known:

  (i) Name of the facility;

  (ii) A patient identifier;

  (iii) Date of visit;

  (iv) Time of visit;

  (v) Patient's age;

  (vi) Patient's gender;

  (vii) Zip code of patient's residence;

  (viii) Chief complaint(s), reason for visit, and/or diagnosis; and

  (ix) Whether the patient was admitted to the hospital.