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48-Hour Hospital Overdose Reporting
Requirements
Pursuant to the Illinois Hospital Licensing Act and Administrative Rule 77 IAC 250.1520 (g): When a drug overdose treatment is provided in a hospital’s emergency department (ED), the case shall be reported to the Illinois Department of Public Health (IDPH) within 48 hours after providing treatment for the drug overdose – or at such time the drug overdose is confirmed.
Reports are to include:
- The cause of the overdose, either by prescription or illicit opioid, along with age, sex, county, ZIP code, race, and ethnicity
- Reporting of opioid antagonist administered by hospital in the ED, with the name of the antagonist is also required
The identity of the person and hospital reporting shall not be disclosed to the subject of the report.
Implementation – Opioid Overdose Reporting
IDPH uses syndromic surveillance, an existing automated reporting mechanism, to allow hospitals to fulfill the mandate without manual reporting for all data elements except opioid antagonist administration.
What hospitals need to do
- Hospitals need to complete a validation process to ensure the automated reporting is accurately capturing the opioid overdose counts
- Hospitals need to set up an automated report in addition to syndromic surveillance for the reporting of naloxone administrations (Syndromic surveillance cannot capture that information at this time)
For Validation Annually
Each hospital will query internal data to determine an accurate count of the number of opioid overdoses presented to the ED between July 1 and September 30 of the validation year. The IDPH definition used in syndromic surveillance is provided below as a reference for the hospital.
To facilitate IDPH investigation into data discrepancies, it is preferred that the following also be reported:
- Description of query method used for count of opioid overdoses
- File with list of Visit IDs for the opioid overdose count
| Search field | Query Logic Used By IDPH |
|---|---|
| Diagnosis - ICD-10 | T40.0 - T40.6 F11.12, F11.22, F11.92 |
| Chief complaint - Text | Poison, overdose, nodding, snorting, ingesting, intoxication, unresponsive, loss of consciousness, shortness of breath, or altered mental status AND reference to heroin, speedball, dope, opioid/opiate/opium, methadone, suboxone, oxyco/oxy/oxymor, Percocet, Vicodin, fentanyl, hydrocodone, morphine, codeine, dilaudid, tramadol, buprenorphine, Synthetic OR F11.10, F11.20, F11.90 |
| Chief complaint - Text | Reference to Narcan or naloxone |
| Excluding | Denials of heroin, drug use, withdraw, detoxification, T40.5 |
IDPH will review the hospitals’ validation and initiate follow-up conversations where reporting is incomplete or inaccurate. IDPH staff will work with hospitals that report discrepant validation results. Most solutions to improve automated reporting may be accomplished through a technical update to the syndromic surveillance feed. The most frequent reasons that a hospital’s syndromic data may not capture the overdoses accurately are:
- A chief complaint that lacks detail on cause, such as only stating ‘OD,’ ‘overdose,’ or ‘drug reaction’
- If the chief complaints come from a pick list, this may be difficult to edit
- If the chief complaints come from a pick list, this may be difficult to edit
- Diagnosis data is incomplete or received with a significant delay
Implementation – Opioid Antagonist Administration Reporting
Hospitals must report any opioid antagonist administered in the hospital ED to IDPH. This information is not captured through syndromic surveillance and requires hospitals to generate a separate electronic report from their pharmacy system.
What hospitals need to do
Send opioid antagonist administration data to IDPH daily
- On a daily basis, hospitals must send a separate report created from the hospital ED pharmacy data capturing opioid antagonists administered in the past 48 hours. Hospitals will export this report from the pharmacy data as a pipe or comma delimited file with .csv extension. Required elements of the report:
| Element | Description |
|---|---|
| Facility ID | Same facility ID your hospital is using in MSH4.2 for SS HL7 messages |
| Patient ID | The same patient unique ID you are using in PID3.1 for SS HL7 message |
| Date | Date when the opioid antagonist was administered |
| Medication Name | Name of the opioid antagonist |
| Medication Code | RxNorm or other code system |
| Dose | Milligrams |
| VisitID | The same visit ID you are using in PV1.19 for SS HL7 message |
To transfer this report to IDPH, each hospital will use the same secure transfer method it is using for syndromic surveillance reporting (i.e., SFTP or VPN). The opioid antagonist .csv report will be dropped to the same folder in which the syndromic surveillance files are located.
Hospitals must utilize the following
Existing SFTP connection to IDPH:
- URL: moveit.illinois.gov
- IP Address: 163.191.60.21 port 22
Directory for Uploads: /Distribution/DPH/SS-HL7/
Naming convention for report files: NPI_YYYYMMDD.csv
Example
Facility with NPI number: 123456789
File production date of: 2017/08/01 (i.e., August 1, 2017)
The file name would be: 123456789_20170801.csv
IDPH will link the records in the opioid antagonist report to the opioid overdose cases captured through syndromic surveillance report based on the Visit ID and the Facility ID.
Email IDPH’s Division of Patient Safety and Quality at dph.dpsq@illinois.gov.