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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 that have set up an automated report in addition to syndromic surveillance for the reporting of naloxone administrations should continue with automated reporting (Syndromic surveillance cannot capture that information at this time). If this is not yet set up, IDPH will explore alternative options for reporting this measure. New on-boarding is on hold.
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
Email IDPH’s Division of Patient Safety and Quality at dph.dpsq@illinois.gov.
