Coding errors meant 504,000 COVID-19 test results were not previously reported to the state, Texas DSHS says

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AUSTIN (Nexstar) — The Department of State Health Services said it has been working to address multiple coding errors that have lead to backlogs of testing data being reported by the state.

Most recently, DSHS discovered over the weekend that Walgreens experienced a coding error in its test reporting. Once the issue was resolved, 59,000 test results filtered through the state’s system.

DSHS spokesperson Lara Anton said the backlog did not affect patient notification, however. “Patients are notified by their health care provider. So, they were notified when their test results came back,” Anton explained.

Walgreens issued a statement responding to the error, explaining in part, “We have worked closely with state officials in Texas on our COVID-19 testing efforts, and immediately assessed the reporting issue when we learned of it on Monday. There was a discrepancy between state requirements for coding and what was being delivered. Our physician network partner, who is responsible for reporting COVID-19 test results to the state, has been working diligently with local officials and the problem has been rectified.”

This is not the only coding error the state has dealt with.

The first issue arose when the state’s processing system was only able to take in 48,000 tests per day, which was an issue when the state was testing more than 60,000 people a day in July. According to DSHS, the system was upgraded Aug. 1, and is now able to take in 100,000 a day.

The two large spikes seen in August are when the Christus and Walgreens backlogs were finally processed through the state’s data system.

That backlog was then cleared within the first week of August, according to DSHS.

Then, DSHS said there was a coding issue with Quest Diagnostics’ labs. Quest began reporting in two different data streams, and there was a coding issue with the new second stream, which was not able to upload into the state’s system.

DSHS said once it was able to find the error with the code, 350,000 results came in from Quest which was still being processed early last week.

Quest Diagnostics issued the following statement, explaining it initially learned of the error in May and it has since been resolved:

This was not a Quest reporting issue. The Texas department of health changed its PHINMS server (where the public health ELRs are sent) in preparation for moving HL7 2.5.1 feed into production and did not tell Quest about the new PHINMS server, so Quest was sending the HL7 2.3.1 feed to their old PHINMS server not realizing that Texas DOH wasn’t receiving them. We were first alerted on May 7 that there was an issue. We immediately worked with Texas DOH to trouble shoot the issue that day. The data feed issue has since been resolved.

Quest Diagnostics

DSHS reported another lab for a hospital system in Northeast Texas, Christus Meditech, also had a coding error. That caused another 95,000 results to come through the system once the issue was resolved.

These backlogs are causing issues for local health departments across the state.

“Local health departments are having to cross-reference these test results to figure out if it’s a duplicate notification, or if it’s an older but previously unreported case that they need to include into their case counts,” Anton explained.

“We expect that’ll be a few more days before we really see the sort of the final downstream of these three backlogs where they all show up in case counts for local jurisdictions,” Anton said.

DSHS said these backlogs could also explain why the state’s 7-day positivity rate increased so much this month.

“Once those testing numbers started to decline and then the numerator, for that was higher because these older test results were coming through, you saw that positivity rate go way up. And then when the backlog came through that had didn’t have, you know, that had a high number of negative tests<” Anton explained.

DSHS said the governor is aware of the issues.

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