Homepage Fill Out a Valid Ph1600 Tennessee Form
Article Map

Understanding the importance of timely and accurate disease reporting in Tennessee is crucial for maintaining public health and safety. The Tennessee Department of Health has mandated the use of the PH-1600 form to ensure that hospitals, physicians, laboratories, and others promptly report communicable diseases and events that could pose a threat to the public. This form, a key element in the state’s communicable disease control efforts, outlines a variety of conditions—from acute infectious diseases to potential bioterrorism indicators—that require different levels of notification to local health departments. With immediate telephonic notification for certain urgent conditions and written reports for others within specified timeframes, the PH-1600 form serves as a critical tool in the rapid identification and management of public health threats. It also details the necessary demographic, clinical, and laboratory information that must be provided for each case, thereby enabling health authorities to take appropriate and timely action. For healthcare providers and laboratories, understanding how to properly complete and submit this form is not just a regulatory requirement; it's a fundamental aspect of contributing to the collective effort to safeguard the health of Tennessee’s communities.

Example - Ph1600 Tennessee Form

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

Form Breakdown

Fact Name Fact Detail
Form Identification The form used for reporting is the PH-1600, revised as of January 2011, under the document number RDA-2094.
Governing Law The statutes and regulations for the control of communicable diseases in Tennessee are encompassed under T.C.A. §68 Rule 1200-14-01-.02.
Reporting Requirements Diseases and events listed require reporting by hospitals, physicians, laboratories, and others knowledgeable of a suspected case, adhering to local health department guidelines.
Notification and Reporting Categories The form categorizes diseases/events requiring immediate telephonic notification (Category 1A & 1B), followed by a written report, among other specification categories for reporting within specific time frames.
Communication Channels For guidance, Communicable and Environmental Disease Services can be contacted at (615) 741-7247 or toll-free at (800) 404-3006.

Detailed Instructions for Filling Out Ph1600 Tennessee

Filling out the PH1600 Tennessee form is a critical step in ensuring that communicable and potentially dangerous diseases are reported efficiently and accurately to the local health department. This process not only helps in monitoring and managing public health risks but also in initiating prompt interventions to prevent further spread. After completing the form, it should be submitted following the specific reporting category requirements, either through immediate telephonic notification or within the agreed timeline for written reports. Here's a step-by-step guide to help you fill out the form correctly.

  1. Download the PH1600 form from the designated Tennessee Department of Health website or obtain a copy from the local health department.
  2. Review the Reportable Diseases and Events Matrix on the health department's website to understand the specifics of what needs to be reported based on the situation at hand.
  3. Begin by entering the Disease/Event Code at the top of the form. Refer to the matrix for the appropriate code.
  4. Fill in the Patient Name, including first and last names.
  5. Enter the Date of Birth with the format MM/DD/YYYY.
  6. Mark the appropriate Race category by checking the corresponding box. If 'Other' is selected, specify the race in the provided space.
  7. Select the Gender of the patient by checking either the 'Male' or 'Female' box.
  8. Choose the Ethnicity by checking the 'Hispanic' or 'Not Hispanic' box. If 'Other' is selected, specify in the provided space.
  9. Provide the patient’s Street Address, City, State, County, and Zip Code.
  10. Enter the Phone number with area code.
  11. Fill in the Onset Date of the disease/event using the MM/DD/YYYY format.
  12. Indicate if the patient Died, Pregnant, or Hospitalized by checking the appropriate box. If uncertain, select 'Unknown'.
  13. If hospitalized, provide the Admission and Discharge Dates, again in the MM/DD/YYYY format.
  14. For applicable cases, note the STD Treatment Date and the STD Treatment details.
  15. Enter the Physician Name and the Facility/Hospital Name where treatment was received, along with the corresponding Phone number.
  16. Document any Laboratory Test information, including Specimen Collection Date, Result, and Specimen Source.
  17. Finally, at the bottom of the form, fill in the Date of Report, the name and title of the Person Reporting, and their Phone number.
  18. Once the form is fully completed, ensure all information is accurate and submit it according to the directions provided for the specific category of the reported disease or event. Timeliness and accuracy in this reporting process are crucial for effective public health surveillance and response activities.

More About Ph1600 Tennessee

What is the PH-1600 form used for in Tennessee?

The PH-1600 form is a crucial document used in Tennessee to report communicable and/or dangerous diseases and events to the local health department. Hospitals, physicians, laboratories, and other individuals who are aware of or suspect a case must file this report. This procedure is in accordance with the statutes and regulations governing the control of communicable diseases in Tennessee.

Who is required to report using the PH-1600 form?

All hospitals, physicians, laboratories, and other persons who know of or suspect a case of a reportable disease or event are required to report to the local health department using the PH-1600 form. This reporting is crucial for the control of communicable diseases within the state.

What types of diseases or events need to be reported on the PH-1600 form?

There are several categories of diseases and events that need to be reported, including but not limited to:

  1. Immediate telephonic notification required diseases such as Anthrax, Meningococcal Disease.
  2. Diseases requiring the next business day telephonic notification followed by a written report such as Brucellosis, Diphtheria.
  3. Conditions requiring a written report within 1 week like Campylobacteriosis, Chlamydia trachomatis-Genital, and more.
  4. Special confidential reporting conditions such as AIDS and HIV.
  5. Monthly reports for healthcare associated infections and blood lead levels.

How can one obtain the Reportable Diseases and Events Matrix?

The Reportable Diseases and Events Matrix, which provides more specific details, can be downloaded from the Tennessee Department of Health's website at http://health.state.tn.us/ceds/notifiable.htm . This matrix is an essential resource for determining the specifics of what needs to be reported.

What information is required when filling out the PH-1600 form?

When completing the PH-1600 form, one needs to provide detailed information including, but not limited to:

  • Patient's name, date of birth, race, and gender.
  • Patient's address, phone number, and ethnicity.
  • Disease/event code, onset date, hospitalization, and death information.
  • STD treatment details, if applicable.
  • Provider's name, facility name, and contact information.
  • Laboratory test results, including specimen collection date and result.
Detailed guidance can be found within the form instructions or by contacting the Communicable and Environmental Disease Services.

What is the deadline for reporting diseases or events using the PH-1600 form?

The deadline for reporting diseases or events using the PH-1600 form varies depending on the disease or event category but generally requires immediate telephonic notification or a written report within 1 week. Specific categories may have different reporting requirements such as next business day notification or monthly reports for specific conditions.

Where should the completed PH-1600 form be submitted?

The completed PH-1600 form should be submitted to the local health department in Tennessee. For diseases or events requiring immediate notification, telephonic communication should be made as well, using the contact numbers provided by the Tennessee Department of Health.

Who can I contact for further guidance or clarification regarding the PH-1600 form?

For further guidance or clarification, you can contact the Communicable and Environmental Disease Services at (615) 741-7247 or (800) 404-3006. They provide assistance and can answer any specific questions related to the PH-1600 form and the reporting process.

Common mistakes

Filling out the PH-1600 form for the Tennessee Department of Health is a critical step in the timely reporting of communicable and dangerous diseases. Mistakes can delay this process, impacting public health responses. Here are ten common mistakes people make when completing this form:

  1. Not reporting immediately by phone for diseases that fall under Category 1A and 1B. These require initial telephonic notification within specific time frames, followed by the written report.
  2. Leaving the Disease/Event Code section blank. Each communicable disease or event has a specific code listed on the form, which must be accurately recorded.
  3. Entering incorrect or incomplete patient demographics, such as spelling errors in the patient's name, incorrect date of birth, or leaving the race and ethnicity sections unchecked.
  4. Omitting contact information, which is crucial for follow-up. The form requires a current phone number and address.
  5. Failing to specify the onset date of symptoms. This information plays a key role in tracing and controlling disease outbreaks.
  6. Not indicating if the patient was hospitalized, died, or if a pregnant patient was affected. These details are vital for assessing the severity of the disease’s impact.
  7. Skipping the sections related to STD treatment and laboratory tests. Even if these do not apply, marking them as "N/A" or "Unknown" helps clarify that they were not overlooked.
  8. Forgetting to include the physician or reporting facility's contact information. This should include the name, facility or hospital name, and a phone number.
  9. Overlooking the Date of Report and the Person Reporting/Title section at the end of the form. This confirms who completed the form and when.
  10. Incorrect categorization of the disease/event. This could delay the appropriate public health response due to miscommunication about the disease’s urgency.

In addition to avoiding these errors, ensuring the form is legible and all applicable sections are completed are best practices for timely reporting. When health professionals pay close attention to detail while filling out the PH-1600, they bolster Tennessee’s efforts in disease surveillance and control, protecting public health.

For more specific guidelines and assistance with the PH-1600 form, communicators are urged to refer to the Reportable Diseases and Events Matrix provided by the Tennessee Department of Health or contact their Communicable and Environmental Disease Services directly.

Documents used along the form

When filling out the PH1600 Tennessee form for reportable diseases and events, it's often necessary to accompany this document with additional forms and documents to ensure a comprehensive report. These supplementary documents help provide a clearer picture of the situation, guide public health actions, and support statistical analyses.

  • Consent for Release of Medical Information: This document is essential in situations where sharing of patient's health information is necessary for public health purposes. It ensures that such sharing is in compliance with HIPAA regulations, safeguarding the patient's rights and privacy.
  • Laboratory Report Forms: Detailed laboratory results that confirm or aid in the diagnosis of the reported disease or event are crucial. These forms provide specific data, including test types, results, and dates, complementing the PH1600 form's initial notification.
  • Clinical Notes: Including relevant extracts from the patient’s clinical notes can offer context and additional details about the patient's condition, symptoms, diagnosis process, and response to treatment not fully captured in the structured format of the PH1600.
  • Epidemiological Questionnaires: For certain communicanle diseases, specialized epidemiological questionnaires that gather detailed information about potential sources of infection, risk factors, and contacts may be required. These are particularly important for diseases with public health implications, such as foodborne illnesses or vaccine-preventable diseases.

When used together, these documents enrich the report initiated by the PH1600 form, facilitating a more effective public health response. It's essential for health professionals to be thorough and timely in the preparation and submission of these documents to support the efforts of public health departments in monitoring, controlling, and preventing communicable diseases within Tennessee.

Similar forms

The PH-1600 Tennessee form, used for reporting communicable diseases and events that pose a risk to the public, shares similarities with various other documents involved in health and safety compliance across the United States. One comparable document is the Morbidity and Mortality Weekly Report (MMWR) case report form used by the Centers for Disease Control and Prevention (CDC). Like the PH-1600 form, the MMWR form collects detailed information on individual cases of notifiable diseases, aiming to monitor and control public health threats.

Another similar document is the California Confidential Morbidity Report (CMR) form, which is used for reporting cases of specific diseases to local health departments in California. Both the CMR and PH-1600 forms require healthcare providers to report detailed patient information, disease specifics, and laboratory results to help track and manage communicable diseases within their respective states.

The New York State Department of Health's Electronic Clinical Laboratory Reporting System (ECLRS) requires laboratories to report results of tests for certain diseases directly to the state. This system's aim aligns with that of the PH-1600 form, focusing on quick and efficient disease reporting to aid in public health surveillance and intervention efforts.

The Report of Communicable Disease form used by the Chicago Department of Public Health has a similar goal to the PH-1600, focusing on the rapid identification and intervention for communicable diseases within the city. Both documents emphasize timely reporting and include provisions for urgent communicative diseases requiring immediate notification.

Florida's Merlin system, an online disease surveillance and outbreak management system, facilitates the reporting and tracking of diseases in a manner akin to the PH-1600 form. While the PH-1600 is a paper document, both it and Merlin collect detailed patient and disease information to assist healthcare professionals and public health officials in disease management and control efforts.

Michigan's Disease Surveillance System is another digital tool that resembles the PH-1600 form in purpose, streamlining the process of illness reporting to enable quicker public health responses. However, the PH-1600's emphasis on a wide range of communicable diseases and events, including those of urgent notification, reflects a comprehensive approach to disease tracking and intervention.

In Texas, the Texas National Electronic Disease Surveillance System (Tx-NEDSS) operates similarly by collecting data on notifiable conditions. Like the PH-1600 form, its primary function is to assist in the monitoring, prevention, and control of diseases that pose a threat to public health.

Oregon's Acute and Communicable Disease Prevention (ACDP) reporting form is used by healthcare providers to report specific diseases to the Oregon Health Authority. Similar to the PH-1600, this form focuses on capturing comprehensive patient and clinical information, underscoring the importance of detailed data for disease tracking and management.

The Electronic Disease Notification (EDN) system employed by the US Department of Health & Human Services for reporting conditions in refugees and immigrants shares a common goal with the PH-1600. Both are designed to protect public health by ensuring rapid and accurate reporting of conditions that may require interventions to prevent spread.

Lastly, the Confidential Sexually Transmissible Disease Case Report forms used across various states for reporting sexually transmitted infections (STIs) mirror the intent of the PH-1600 form. Although focused on a specific subset of diseases, these forms similarly collect detailed patient data to aid in the investigation, treatment, and prevention of STIs, reflecting a shared goal of disease control and prevention.

Dos and Don'ts

When completing the PH1600 Tennessee form for reportable diseases and events, it is crucial to follow specific guidelines to ensure accurate and timely reporting. Here are seven key dos and don'ts to consider:

  • Do review the list of reportable diseases and events before filling out the form to ensure the specific case meets the reporting criteria.
  • Do provide complete patient information, including full name, date of birth, race, gender, and contact details, to enable effective follow-up and data accuracy.
  • Do accurately enter the disease/event code from the provided list to prevent processing delays and ensure correct case management.
  • Do include detailed clinical information such as date of onset, hospitalization status, and laboratory test results to support public health interventions.
  • Do not leave sections blank; if a particular item does not apply or the information is not available, mark it as 'Unknown' to acknowledge the item was considered.
  • Do not report diseases or events that do not meet the specified criteria for the PH1600 form; this ensures resources are directed appropriately and reduces unnecessary work.
  • Do contact Communicable and Environmental Disease Services for guidance if you are unsure about how to complete the form or whether a disease/event is reportable.

These practices are designed to ensure that the reporting process is both efficient and effective, allowing health officials to take timely action based on accurate and complete information. Following these guidelines helps fulfill the legal and ethical obligation to safeguard public health in Tennessee.

Misconceptions

  • One common misconception about the PH-1600 form is that it is only for use within hospitals. In reality, the form must be used by hospitals, physicians, laboratories, and other individuals who have knowledge of or suspect a communicable and/or dangerous disease.

  • Many believe that the PH-1600 form involves a lengthy and complicated reporting process. However, the form is designed to streamline the notification of reportable diseases to the local health department, following specific statutes and regulations.

  • There is a misconception that the PH-1600 form only covers a few diseases. The truth is, the form is comprehensive and includes a wide variety of reportable diseases and events, from Anthrax to Yellow Fever, as well as Healthcare Associated Infections.

  • Some people think that once you've reported a disease using the PH-1600 form, no further action is required. In reality, some diseases require immediate telephonic notification in addition to the written report, emphasizing the urgency of certain conditions.

  • It's a common misunderstanding that the PH-1600 form is a voluntary reporting tool. Reporting diseases and events listed on the form is actually mandated by Tennessee law, under specific statutes (T.C.A. §68 Rule 1200-14-01-.02), making it a legal requirement.

  • Another misconception is that personal patient information is not protected when reported through the PH-1600 form. Patient confidentiality is a priority, and the form is part of a secure process intended to protect individual privacy while ensuring public health and safety.

  • Many assume that all communicable diseases must be reported with the PH-1600 form. However, the form specifies which diseases and events require reporting, separating them into different categories based on urgency and reporting requirements.

  • Some believe the reporting through the PH-1600 is only relevant for Tennessee residents. While the form is for diseases and events occurring within Tennessee, it is crucial for monitoring and preventing the spread of diseases that can affect both residents and visitors.

  • Finally, there's a misconception that reporting is only the responsibility of medical professionals. The form clarifies that laboratories and other entities, such as schools or childcare facilities, may also have responsibilities in reporting certain conditions.

Key takeaways

  • The Tennessee Department of Health requires the reporting of certain diseases and events that are communicable and/or considered dangerous to the public. This is enforced under the statutes and regulations that govern the control of communicable diseases in Tennessee.
  • Anyone knowing of or suspecting a case, including hospitals, physicians, laboratories, and other entities, must report these diseases and events to the local health department using the form PH-1600.
  • The form PH-1600 includes sections for disease/event code, patient demographics, clinical information, provider details, and laboratory test results, ensuring comprehensive data collection for health monitoring and response.
  • Diseases and events are categorized into different levels based on the urgency of reporting required, ranging from Category 1A, which requires immediate telephonic notification and a written report within one week, to Category 5, which deals with monthly reporting of certain healthcare associated infections.
  • Immediate telephonic notification is vital for some diseases, indicating the need for a rapid response to prevent further spread. The form must then be submitted within a specific timeframe depending on the category of the disease or event.
  • The form also captures essential information about the patient such as race, ethnicity, and clinical details like hospitalization status, pregnancy status, and mortality. This detailed reporting helps in understanding the impact of the condition on different population groups.
  • Additional guidelines and a detailed matrix of reportable diseases and events can be found online, providing clarity on reporting requirements and helping ensure compliance with state regulations.
  • Confidentiality is key when dealing with sensitive health information. The form requires careful handling to ensure patient privacy and data protection while enabling health officials to take necessary public health actions.
  • For further assistance or clarification on reporting procedures, the Tennessee Department of Health has provided contact information, offering support to healthcare professionals and institutions in fulfilling their reporting obligations.
Please rate Fill Out a Valid Ph1600 Tennessee Form Form
4.77
Incredible
222 Votes