NC DPH ELR Mapping Tool Submission for Review
Please use this form to submit the ELR Mapping Tool to NC DPH for review as part of Steps 3 and 4 of the ELR onboarding process.
Hospital/ Lab Name
Please indicate the name of the person designated to answer any questions that may arise during the review of the mapping.
Mapping Contact Phone
Mapping Contact Email
Please indicate what mapping stage your hospital is submitting.
Step 3a Reportable Review
Step 3b Reportable Volume Review
Step 4a LOINC Mapping Review
Step 4b SNOMED Mapping Review
Step 4c SNOMED Specimen Type Mapping
Multiple Step Review
Please indicate the number of revisions completed for the current mapping stage. For example, if this is the second submission for Step 3a Reportable Review, enter 2.
Please attach the NC DPH ELR Mapping Tool here. To ensure a timely review, the sheet should be completed per the instructions and include a key for any abbreviations.
The format we are using for the filenames is: <Hospital Name> NC ELR <submission#> <Step#> <initials of submitter or reviewer> <date(YYYY MMDD)>
For the filename of the next file you submit, please increment the submission #, substitute your initials and change the date to the current date.
Date Submitted to NC DPH
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