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In the realm of public health and safety, certain diseases and events stand classified as significant enough to warrant immediate reporting to authorities to ensure the well-being of the community at large. The Tennessee Department of Health has instituted a formal process for such reporting through the utilization of the Ph1600 form. This crucial document serves as the primary mode of communication for hospitals, physicians, laboratories, and other relevant parties to report communicable and dangerous diseases or events as mandated by the statutes and regulations dictating the control of communicable diseases within the state (T.C.A. §68 Rule 1200-14-01-.02). The diseases and events listed require varying levels of urgency in their reporting, ranging from immediate telephone notification to written reports submitted within specific time frames. The Ph1600 form is comprehensive, requiring detailed information about the patient such as demographics, clinical data, and provider details, along with the specific disease or event code. Categories differentiate the urgency and type of report needed, from immediate telephonic notification for critical cases like Anthrax or Novel Influenza A, to monthly reports for issues such as healthcare-associated infections. Special confidential reporting protocols are outlined for particularly sensitive conditions like AIDS and HIV. Furthermore, the form is instrumental in tracking a wide array of health issues, including but not limited to severe infections, toxic exposures, and outbreaks of diseases, thereby aiding in the timely intervention and management of public health threats.

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Tennessee Department of Health Reportable Diseases and Events

The diseases and events listed on the back of this report are declared to be communicable and/or dangerous to the public and are to be reported to the local health department by all hospitals, physicians, laboratories, and other persons knowing of or suspecting a case in accordance with the provision of the statutes and regulations governing the control of communicable diseases in Tennessee (T.C.A. §68 Rule 1200-14-01-.02). For more specific details, download the Reportable Diseases and Events Matrix (http://health.state.tn.us/ceds/notifiable.htm). If further guid- ance is needed, contact Communicable and Environmental Disease Services at (615) 741-7247 or (800) 404-3006.

Disease/Event Code:

 

 

 

 

 

 

Patient Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Birth:

 

Race: □ American Indian / Alaskan

 

____/____/________

 

 

 

Asian

 

Demographics

Gender:

Male

 

 

 

Black / African American

 

Female

 

 

 

Hawaiian / Pacific Islander

 

 

 

 

 

 

White

 

 

Ethnicity: □ Hispanic

 

 

 

 

 

 

 

Other (_________________)

 

 

Not Hispanic

 

 

 

 

 

 

 

 

 

 

 

 

Street Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City:

 

 

 

 

 

 

State:

 

 

 

 

 

 

 

 

 

 

County:

 

 

 

 

 

 

Zip Code:

 

 

 

 

 

 

 

 

 

 

Phone: (

)

 

 

 

 

 

 

 

Onset Date: ____/____/________

 

Information

 

 

 

 

 

 

Died?:

Yes

 

 

Pregnant?:

Yes

 

Hospitalized?: □ Yes

 

 

Admission Date: ____/____/________

 

 

No

 

 

 

 

 

 

 

Unknown

 

 

Discharge Date: ____/____/________

Clinical

 

No

 

 

 

 

No

 

Unknown

 

 

 

 

Unknown

 

 

 

 

 

 

 

STD Treatment Date:

 

 

STD Treatment:

 

____/____/________

 

 

 

 

 

 

 

 

 

 

 

 

 

Provider

Physician Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

Facility/Hospital Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone: (

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Laboratory

Test:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Specimen Collection Date:

Result:

 

 

 

 

____/____/________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Specimen Source:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Disease/Event Code:

 

 

 

 

 

 

Patient Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Birth:

 

Race: □ American Indian / Alaskan

 

____/____/________

 

 

 

Asian

 

Demographics

Gender:

Male

 

 

 

Black / African American

 

Female

 

 

 

Hawaiian / Pacific Islander

 

 

 

 

 

 

White

 

 

Ethnicity: □ Hispanic

 

 

 

 

 

 

 

Other (_________________)

 

 

Not Hispanic

 

 

 

 

 

 

 

 

 

 

 

 

Street Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City:

 

 

 

 

 

 

State:

 

 

 

 

 

 

 

 

 

 

County:

 

 

 

 

 

 

Zip Code:

 

 

 

 

 

 

 

 

 

 

Phone: (

)

 

 

 

 

 

 

 

Onset Date: ____/____/________

 

Information

 

 

 

 

 

 

Died?:

Yes

 

 

Pregnant?:

Yes

 

Hospitalized?: □ Yes

 

 

Admission Date: ____/____/________

 

 

No

 

 

 

 

 

 

 

Unknown

 

 

Discharge Date: ____/____/________

Clinical

 

No

 

 

 

 

No

 

Unknown

 

 

 

 

Unknown

 

 

 

 

 

 

 

STD Treatment Date:

 

 

STD Treatment:

 

____/____/________

 

 

 

 

 

 

 

 

 

 

 

 

 

Provider

Physician Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

Facility/Hospital Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone: (

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Laboratory

Test:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Specimen Collection Date:

Result:

 

 

 

 

____/____/________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Specimen Source:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date of Report: ____/____/________ Person Reporting/Title: ___________________________________________ Phone: ( ______ ) ________________

PH-1600 (Rev. 01/2011)

RDA-2094

Category 1A: Requires immediate telephonic notification (24 hours a day, 7 days a week), followed by a written report using the PH-1600 within 1 week.

[002]

Anthrax (Bacillus anthracis)B

[095]

Meningococcal Disease (Neisseria meningitidis)

[005]

Botulism-Foodborne (Clostridium botulinum)B

[516]

Novel Influenza A

[004]

Botulism-Wound (Clostridium botulinum)

[032]

Pertussis (Whooping Cough)

[505]

Disease Outbreaks (e.g., foodborne, waterborne, healthcare, etc.)

[037]

Rabies: Human

[108]

Encephalitis, Arboviral: Venezuelan EquineB

[112]

Ricin PoisoningB

[023]

Hantavirus Disease

[132]

Severe Acute Respiratory Syndrome (SARS)

[096]

Measles-Imported

[107]

SmallpoxB

[026]

Measles-Indigenous

[110]

Staphylococcal Enterotoxin B (SEB) Pulmonary PoisoningB

Category 1B: Requires immediate telephonic notification (next business day), followed by a written report using the PH-1600 within 1 week.

[006]Brucellosis (Brucella species)B

[010]Congenital Rubella Syndrome

[011]Diphtheria (Corynebacterium diphtheriae)

[121]Encephalitis, Arboviral: California/LaCrosse Serogroup

[123]Encephalitis, Arboviral: Eastern Equine

[122]Encephalitis, Arboviral: St. Louis

[124]Encephalitis, Arboviral: Western Equine

[506]Enterobacteriaceae, Carbapenem-resistant

[053]Group A Streptococcal Invasive Disease (Streptococcus pyogenes)

[047]Group B Streptococcal Invasive Disease (Streptococcus

agalactiae)

[054]Haemophilus influenzae Invasive Disease

[016]Hepatitis, Viral-Type A acute

[513]Influenza-associated deaths, age <18 years

[520]Influenza-associated deaths, pregnancy-associated

Category 2: Requires written report using form PH-1600 within 1 week.

[501]Babesiosis

[003]Botulism-Infant (Clostridium botulinum)

[007]Campylobacteriosis (including EIA or PCR positive stools)

[503]Chagas Disease

[069]Chancroid

[055]Chlamydia trachomatis-Genital

[057]Chlamydia trachomatis-Other

[056]Chlamydia trachomatis-PID

[009]Cholera (Vibrio cholerae)

[001]Cryptosporidiosis (Cryptosporidium species)

[106]Cyclosporiasis (Cyclospora species)

[504]Dengue Fever

[116]Ehrlichiosis-HGE (Anaplasma phagocytophilum)

[051]Ehrlichiosis-HME (Ehrlichia chaffeensis)

[117]Ehrlichiosis/Anaplasmosis-Other

[060]Gonorrhea-Genital (Neisseria gonorrhoeae)

[064]Gonorrhea-Opthalmic (Neisseria gonorrhoeae)

[061]Gonorrhea-Oral (Neisseria gonorrhoeae)

[063]Gonorrhea-PID (Neisseria gonorrhoeae)

[062]Gonorrhea-Rectal (Neisseria gonorrhoeae)

[133]Guillain-Barré syndrome

[058]Hemolytic Uremic Syndrome (HUS)

[480]Hepatitis, Viral-HbsAg positive infant

[048]Hepatitis, Viral-HbsAg positive pregnant female

[017]Hepatitis, Viral-Type B acute

[018]Hepatitis, Viral-Type C acute

[021]Legionellosis (Legionella species)

[022]Leprosy [Hansen Disease] (Mycobacterium leprae)

[094]Listeriosis (Listeria species)

[024]Lyme Disease (Borrelia burgdorferi)

[025]Malaria (Plasmodium species)

[515]Melioidosis (Burkholderia pseudomallei)

[102]Meningitis-Other Bacterial

[031]Mumps

[033]Plague (Yersinia pestis)B

[035]Poliomyelitis-Nonparalytic

[034]Poliomyelitis-Paralytic

[119]Prion disease-variant Creutzfeldt Jakob Disease

[109]Q Fever (Coxiella burnetii)B

[040]Rubella

[041]Salmonellosis: Typhoid Fever (Salmonella Typhi)

[131]Staphylococcus aureus: Vancomycin non-sensitive – all forms

[075]Syphilis (Treponema pallidum): Congenital

[519]Tuberculosis, confirmed and suspect cases of active disease

(Mycobacterium tuberculosis complex)

[113]Tularemia (Francisella tularensis)B

[118]Prion disease-Creutzfeldt Jakob Disease

[036]Psittacosis (Chlamydia psittaci)

[105]Rabies: Animal

[042]Salmonellosis: Other than S. Typhi (Salmonella species)

[517]Shiga-toxin producing Escherichia coli (including Shiga-like

toxin positive stools, E. coli O157 and E. coli non-O157)

[043]Shigellosis (Shigella species)

[039]Spotted Fever Rickettsiosis (Rickettsia species including Rocky

Mounted Spotted Fever)

[130]Staphylococcus aureus: Methicillin resistant Invasive Disease

[518]Streptococcus pneumoniae Invasive Disease (IPD)

[074]Syphilis (Treponema pallidum): Cardiovascular

[072]Syphilis (Treponema pallidum): Early Latent

[073]Syphilis (Treponema pallidum): Late Latent

[077]Syphilis (Treponema pallidum): Late Other

[076]Syphilis (Treponema pallidum): Neurological

[070]Syphilis (Treponema pallidum): Primary

[071]Syphilis (Treponema pallidum): Secondary

[078]Syphilis (Treponema pallidum): Unknown Latent

[044]Tetanus (Clostridium tetani)

[045]Toxic Shock Syndrome: Staphylococcal

[097]Toxic Shock Syndrome: Streptococcal

[046]Trichinosis

[101]Vancomycin resistant enterococci (VRE) Invasive Disease

[114]Varicella deaths

[104]Vibriosis (Vibrio species)

[125]West Nile virus Infections-Encephalitis

[126]West Nile virus Infections-Fever

[098]Yellow Fever

[103]Yersiniosis (Yersinia species)

Category 3: Requires special confidential reporting to designated health department personnel within 1 week.

[500] Acquired Immunodeficiency Syndrome (AIDS)

[512] Human Immunodeficiency Virus (HIV)

Category 4: Laboratories and physicians are required to report all blood lead test results monthly and no later than 15 days following the end of the month.

[514]Lead Levels (blood)

Category 5: Events will be reported monthly (no later than 30 days following the end of the month) via the National Healthcare Safety Network (NHSN

see http://health.state.tn.us/ceds/hai/index.htm for more details); CLOSTRIDIUM DIFFICILE infections (Davidson County residents only) will also be reported monthly to the Emerging Infections Program (EIP).

[508]

Healthcare Associated Infections, Central Line Associated

[510]

Healthcare Associated Infections, Methicillin resistant

 

Bloodstream Infections

 

Staphylococcus aureus positive blood cultures

[509]

Healthcare Associated Infections, Clostridium difficile

[511]

Healthcare Associated Infections, Surgical Site Infections

The following pathogens do not need to be reported using form PH-1600, but a reference culture is required to be sent to the State Public Health Laboratory.

[502] Burkholderia malleiB

[507] Francisella speciesB

 

 

 

 

BPossible Bioterrorism Indicators

See matrix for additional details.

Effective 01/01/2011

Document Data

Fact Name Fact Detail
Form Designation PH-1600
Revision Date January 2011
Governing Law T.C.A. §68 Rule 1200-14-01-.02
Primary Purpose Reporting Communicable and Dangerous Diseases
Reportable Entities Hospitals, Physicians, Laboratories, and Others with Knowledge or Suspicion of Cases
Notification Requirement for Category 1A Diseases Immediate Telephone Notification, Followed by Written Report within 1 Week
Notification Requirement for Category 1B Diseases Immediate Telephone Notification (Next Business Day), Followed by Written Report within 1 Week
Special Reporting Categories Includes Monthly Reporting for Blood Lead Test Results and Healthcare Associated Infections
Contact Information for Guidance Communicable and Environmental Disease Services at (615) 741-7247 or (800) 404-3006

Detailed Guide for Using Ph1600 Tennessee

Filling out the PH1600 form is a critical step in reporting diseases and events that are considered communicable or dangerous to the public health in Tennessee. This procedure plays a crucial role in the efforts to monitor, control, and prevent the spread of diseases within the community. When you're ready to report, having all necessary information at hand will simplify the process. Below are the steps you'll need to follow to accurately complete the PH1600 form.

  1. Download or access a copy of the PH1600 form from the Tennessee Department of Health's website or obtain a hard copy from a local health department office.
  2. Start with the "Disease/Event Code" section. Refer to the list provided in the form instructions or the Reportable Diseases and Events Matrix on the Tennessee Department of Health website to find the correct code for the disease or event you're reporting.
  3. Enter the "Patient Name" as it appears on their medical records.
  4. Fill in the "Date of Birth" of the patient using the MM/DD/YYYY format.
  5. Select the appropriate "Race" category that best describes the patient. If the patient's race is not listed, choose "Other" and specify in the space provided.
  6. Tick the appropriate "Gender" box to indicate whether the patient is male or female.
  7. For the "Ethnicity" question, mark whether the patient identifies as Hispanic or not Hispanic. If the options do not apply, choose "Other" and specify in the provided space.
  8. Enter the patient's "Street Address," "City," "State," "County," and "Zip Code." These details are essential for local health departments to accurately track and manage reported diseases and events.
  9. Provide the "Phone" number where the patient can be reached or the number of a contact person.
  10. Record the "Onset Date" of the disease or event, using the MM/DD/YYYY format. If the exact date is unknown, provide an estimated date.
  11. Answer the questions about the patient's condition—whether they have "Died?", "Pregnant?", and "Hospitalized?" by checking Yes, No, or Unknown. Fill in the "Admission Date" and "Discharge Date" if applicable.
  12. If the disease or event requires details about "STD Treatment," provide the date of treatment and any relevant information.
  13. Under "Provider Information," input the "Physician Name," "Facility/Hospital Name," and their "Phone" number.
  14. In the "Laboratory Test" section, specify the type of test, "Specimen Collection Date," "Result," and "Specimen Source."
  15. Finally, complete the "Date of Report," and include the name and title of the "Person Reporting" along with their contact phone number.
  16. Review the form to ensure all information is accurate and complete. If reporting is required immediately, first notify the Communicable and Environmental Disease Services via the phone numbers provided, then submit the completed PH1600 form according to the instructions on the form.

After the form has been filled out completely, it should be submitted to the local health department as soon as possible. Timely reporting is essential for effective public health intervention and the prevention of disease outbreaks. If you have any questions during this process or require further guidance, don't hesitate to contact the Communicable and Environmental Disease Services for assistance.

Important Questions on This Form

What is the purpose of the PH-1600 form in Tennessee?

The PH-1600 form is used by the Tennessee Department of Health for the reporting of communicable and dangerous diseases. Hospitals, physicians, laboratories, and other individuals who are aware of or suspect a case of any reportable diseases are required to fill out this form. The aim is to enhance public health by ensuring that the local health departments are informed about potential health threats so that appropriate measures can be taken to prevent and control the spread of diseases.

Which diseases are reportable on the PH-1600 form?

The diseases and events that must be reported include a wide range of communicable diseases, from common illnesses like influenza to more rare and serious conditions such as anthrax, botulism, and severe acute respiratory syndrome (SARS). The form categorizes diseases into different levels of urgency for reporting, including immediate telephonic notification and diseases that can be reported within one week. For a complete list of reportable diseases, refer to the Reportable Diseases and Events Matrix linked in the form instructions.

How and when should the PH-1600 form be submitted?

The submission guidelines for the PH-1600 form vary based on the urgency category of the reportable disease:

  1. Category 1A diseases require immediate telephonic notification 24/7, followed by a written report using the PH-1600 form within 1 week.
  2. Category 1B diseases also need immediate telephonic notification on the next business day, with a written report to follow within 1 week.
  3. Category 2 diseases, and others categorized for special confidential reporting or monthly reporting, have specific timelines mentioned in the form instructions. Written reports using the PH-1600 form should be submitted according to these timelines.
Detailed instructions on where and how to submit the form can be found within the PH-1600 document and accompanying guidelines provided by the Tennessee Department of Health.

What information is required on the PH-1600 form?

The PH-1600 form requires comprehensive information about the patient, the disease or event, and the reporting entity. This includes the patient's name, date of birth, race, gender, ethnicity, contact details, disease or event details such as onset date, hospitalization, and outcome. Additionally, information about the provider, laboratory tests, and the person reporting is necessary. It's essential to provide complete and accurate information to ensure the health department can take appropriate public health actions.

Where can I find more guidance on completing the PH-1600 form?

For detailed instructions and additional guidance on filling out the PH-1600 form, reporting entities can visit the official Tennessee Department of Health website or contact the Communicable and Environmental Disease Services directly via phone. The official website also offers a downloadable Reportable Diseases and Events Matrix, which provides specifics on what needs to be reported and how to report it correctly. Legislative references and contact details for further questions or clarifications are provided within the form instructions.

Common mistakes

When filling out the PH1600 Tennessee form, one common mistake is inaccurate disease/event codes. These codes are critical for the health department to correctly identify reported diseases or events. Using the wrong code can lead to miscommunication and improper handling of the report.

Another frequent error is leaving the demographic section incomplete. Every piece of information, from the patient's name and date of birth to their race, gender, and ethnicity, is crucial. These details help in the proper assessment and response to the reported condition. Missing information can complicate or delay necessary public health actions.

Incorrect or incomplete contact and address details also cause issues. This includes the patient's phone number and address, as well as the contact information for the physician or reporting facility. Accurate contact information ensures that health officials can perform follow-ups for additional information or to notify of required actions.

A common oversight is failing to provide complete clinical information, such as the date of symptom onset, hospitalization details, and outcomes like recovery or death. This information is vital for understanding the severity and spread of the disease. Without it, health officials may not be able to assess the risk to the public accurately.

Lastly, there's often a lapse in reporting laboratory test results accurately, including the specimen collection date and the result itself. This data is essential for confirming the diagnosis and understanding the disease's prevalence within the community. Inaccurate or missing lab results can hinder the health department's ability to make informed decisions and provide appropriate public health responses.

  1. Using incorrect disease/event codes.
  2. Leaving demographic information incomplete.
  3. Providing incorrect or incomplete contact and address details.
  4. Omitting vital clinical information.
  5. Failing to accurately report laboratory test results.

Ensuring accuracy and completeness in these areas can significantly improve the effectiveness of public health reporting and interventions.

Documents used along the form

When working within the public health field in Tennessee, particularly involving communicable and dangerous diseases, the PH1600 form plays a pivotal role. However, completing this form often requires supplementary documents and forms to provide a comprehensive report. Understanding these additional documents can help streamline the reporting process and ensure all necessary information is accurately conveyed.

  • Patient Consent Form: This document is crucial for ensuring that the patient’s information is being shared with their consent, respecting their privacy and rights under health laws.
  • Physician’s Report: Often accompanies the PH1600 to provide detailed medical observations, diagnosis, and treatment information from the healthcare provider's perspective.
  • Laboratory Test Results: Integral for confirming the diagnosis of the disease or event being reported. This can include blood tests, cultures, or any other relevant laboratory findings.
  • Epidemiological Investigation Report: Used in cases where an outbreak is suspected, detailing the investigation’s findings, including how the disease may be spreading and possible sources of the outbreak.
  • Vaccination Records: Essential for communicable diseases preventable by vaccine, as they provide the vaccination status of the patient which can be crucial in outbreak prevention and control.
  • Contact Tracing Forms: Helps in identifying individuals who may have been exposed to the communicable disease, so that they can be advised on next steps, monitored for symptoms, or provided with preventive treatment.
  • Hospital Admission and Discharge Summaries: These documents provide context on the patient’s condition during hospital stays, relevant treatments administered, and the patient’s status at discharge, contributing to a full understanding of the case.

Each of these documents contributes a piece to the larger picture of public health monitoring and control. Together with the PH1600, they enable health professionals and authorities to take informed actions, aiming to protect the well-being of Tennessee's residents effectively. It's important to be familiar with these forms and documents, ensuring they are used properly and efficiently in the fight against communicable diseases.

Similar forms

The PH-1600 Tennessee form is quite similar to the California Confidential Morbidity Report. Both documents are integral to public health departments for tracking the incidence and spread of reportable diseases within their respective states. They mandate healthcare professionals and laboratories to report specific communicable diseases, aiming to prevent and control outbreaks. Each form lists various diseases, along with detailed information requirements about the patient, diagnosis, and laboratory findings, ensuring a structured and efficient data collection process for health authorities.

Similarly, the New York State DOH Communicable Disease Reporting Form serves the same purpose as the Tennessee PH-1600 form, requiring health practitioners and laboratories to report notifiable diseases. Both documents are crucial in the public health effort to monitor, manage, and mitigate the risks of communicable diseases. They contain sections for personal and clinical information, ensuring that health departments receive comprehensive data on each case to facilitate timely and effective responses to protect public health.

The Texas Notifiable Conditions Report mirrors the functionality and intent of the PH-1600 form, emphasizing the importance of timely disease reporting in managing public health concerns. By mandating the reporting of certain diseases, both forms play a pivotal role in the early detection of outbreaks, allowing for swift public health interventions. Each form meticulously outlines the required information for reporting, including patient identifiers and clinical details, to ensure a thorough epidemiological analysis.

Florida's Practitioner Disease Report Form also shares similarities with Tennessee's PH-1600 form. Designed to track and manage the spread of communicable diseases, these documents are crucial tools for public health departments. By establishing a systematic reporting protocol, they assist in the rapid identification and containment of health threats, with both emphasizing the need for detailed patient and disease information to facilitate public health actions.

The Illinois Morbidity and Mortality Report is another document akin to Tennessee's PH-1600 form, focusing on the surveillance of communicable diseases. Both forms are designed to gather detailed information on reportable diseases from healthcare providers, ensuring that health departments have the data necessary to initiate preventative actions and manage disease outbreaks effectively. This proactive approach in collecting and analyzing data is vital for maintaining public health and safety.

The Pennsylvania Disease Reporting Form operates under the same principles as the Tennessee PH-1600 form, emphasizing the importance of surveillance in controlling disease spread. Through these documents, health authorities can monitor disease trends, identify outbreaks, and implement control measures to protect the community. Both forms require comprehensive data on patients, clinical outcomes, and laboratory results, underscoring the role of accurate reporting in disease management and prevention.

The Michigan Disease Surveillance System is complemented by reporting forms akin to Tennessee's PH-1600, both crucial for detecting and responding to public health threats. By streamlining the reporting process for communicable diseases, they enable health departments to conduct timely investigations and interventions. The detailed reporting criteria outlined in these forms help public health officials track disease patterns and make informed decisions to safeguard the community's health.

Similarly, the Oregon Acute and Communicable Disease Reporting Form shares objectives with the Tennessee PH-1600 form in its role in public health surveillance. These documents are instrumental in collecting data on disease incidence and spread, allowing for a coordinated response to health emergencies. By providing a framework for reporting, they ensure a consistent and effective approach to disease control and prevention across the state.

The Washington State Notifiable Conditions Reporting Form is another counterpart to the Tennessee PH-1600 form, exemplifying the nationwide effort to monitor and control the spread of communicable diseases. Both forms are critical tools for public health authorities, facilitating the early detection of outbreaks and enabling rapid response to protect public health. With sections dedicated to detailed patient information, clinical data, and laboratory results, they ensure comprehensive disease surveillance.

The Nebraska Department of Health and Human Services Disease Report, like the Tennessee PH-1600 form, mandates the reporting of certain diseases to help manage and control their spread. These documents serve a common purpose of safeguarding public health through the systematic collection and analysis of disease data. By requiring detailed submissions from healthcare providers and laboratories, they lay the foundation for effective public health interventions, illustrating a shared commitment to preventing disease outbreaks.

Dos and Don'ts

When filling out the PH1600 Tennessee form, it's crucial to ensure accuracy and adherence to the guidelines to help the Tennessee Department of Health in tracking, controlling, and preventing communicable diseases. Below are the dos and don'ts to consider:

  • Do verify the accuracy of all patient information you provide, including the patient's name, date of birth, address, and phone number.
  • Do check the appropriate boxes for the patient's race, gender, and ethnicity to ensure demographic information is complete.
  • Do provide detailed information about the disease or event being reported, including the correct disease/event code.
  • Do include accurate dates for the onset of the disease, hospital admission, discharge, and any treatment provided.
  • Do ensure that the laboratory test results, specimen collection dates, and sources are correctly filled out if applicable.
  • Do not leave any required fields blank. If a section does not apply, indicate this with "N/A" or "Unknown" as appropriate.
  • Do not guess information. Confirm all details, especially when reporting critical information like laboratory test results and dates.
  • Do not use abbreviations or medical jargon that is not widely recognized. Keep the language clear and accessible.
  • Do not report diseases or conditions that do not need to be reported on the PH1600 form, according to the guidelines and reportable diseases matrix.
  • Do not forget to sign and date the form, and ensure that the person reporting/title section is completed with accurate contact information for follow-up.

By adhering to these guidelines, you'll contribute to a smoother reporting process, aiding the Tennessee Department of Health in their critical work towards public health safety and disease prevention.

Misconceptions

When discussing the PH-1600 Tennessee form, there are a few misconceptions that frequently arise. Understanding these can help in accurately completing and submitting this essential document.

  • Only hospitals and physicians need to report: This is incorrect. Besides hospitals and physicians, laboratories, and other individuals who know or suspect a case of a reportable disease or event must report to the local health department. This broader requirement ensures comprehensive tracking and management of public health concerns.

  • All diseases are treated equally: The form outlines different categories for diseases and events, each requiring specific timelines for reporting. For instance, Category 1A diseases require immediate telephonic notification and a written report within a week, while Category 2 diseases only need a written report within the same timeframe. Recognizing these distinctions is crucial for timely and appropriate responses.

  • The form is only for reporting infectious diseases: While infectious diseases constitute a significant part of the reportable conditions, the PH-1600 is also used for reporting non-infectious events and conditions that pose a public health risk. This includes environmental health hazards and certain blood lead level results, underscoring the form’s role in a broad spectrum of public health surveillance.

  • Reporting is only meaningful for severe cases: Every instance of a reportable disease or event, regardless of severity, must be reported. This comprehensive reporting aids in monitoring trends, managing outbreaks, and understanding the public health implications of both mild and severe cases.

  • Personal patient information is not necessary for reporting: Accurate and complete patient information is essential for the reporting process. This includes demographics, disease onset, and clinical outcomes. Such information enables health officials to perform contact tracing, evaluate disease spread, and implement control measures. Anonymity is maintained in accordance with privacy laws, but the collection of this data is vital for public health efforts.

Clearing up these misconceptions facilitates better communication between healthcare providers and public health departments, ensuring that reportable diseases and events are accurately tracked and managed across Tennessee.

Key takeaways

The PH-1600 Tennessee form is an essential document for the reporting of certain diseases and events that are considered communicable or dangerous to the public health. Given its importance in ensuring public safety and the prevention of disease outbreaks, understanding how to properly fill out and use this form is crucial for medical professionals, laboratories, and other relevant entities in Tennessee. Below are key takeaways for handling this important paperwork.

  • The form is designed for the reporting of diseases and events to the local health department in adherence to Tennessee statutes and regulations on communicable diseases.
  • Immediate reporting is necessary for diseases classified under Category 1A, requiring telephonic notification followed by a written report within one week.
  • Category 1B diseases also need immediate notification the next business day, followed by a written report within one week.
  • For diseases listed under Category 2, a written report via the PH-1600 form must be submitted within one week.
  • Category 3 includes diseases that require special confidential reporting to designated health department personnel within one week.
  • Reporting for Category 4, which includes all blood lead test results, should be done monthly and no later than 15 days following the end of the month.
  • Events under Category 5 should be reported monthly, no later than 30 days following the end of the month, mainly through the National Healthcare Safety Network (NHSN).
  • Some pathogens do not need to be reported using the PH-1600 form but require sending a reference culture to the State Public Health Laboratory.
  • Information needed on the form includes disease/event code, patient demographics, clinical information, provider information, and laboratory test details.
  • The form is available for detailed viewing and download at the Tennessee Department of Health's website, providing accessible assistance for users.
  • For any questions or further guidance on how to fill out or submit the form, contact Communicable and Environmental Disease Services.

Properly filled out and timely submitted, the PH-1600 form is a fundamental tool in the state of Tennessee's efforts to control the spread of communicable diseases and protect the health of the public. Awareness and understanding of the correct use of this form are paramount for those responsible for its submission.

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