Improving Case Reporting Nationwide

Updated October 19, 2022


Healthcare facilities nationwide are making the switch from traditional case reporting to electronic case reporting (eCR). eCR moves patient data quickly, securely, and seamlessly from electronic health records (EHRs) in healthcare facilities to state, local, and territorial health departments. These data are more complete and include patient demographics (e.g., race and ethnicity), diagnoses, comorbidities, occupation, travel history, immunizations, medications, pregnancy status, and other treatments. eCR also enables immediate feedback from public health agencies to healthcare providers about reportable conditions and possible outbreaks, which is especially critical during public health emergencies.

Implementing eCR requires action from partners in health information technology, public health agencies, and healthcare organizations. When COVID-19 became a reportable condition in all jurisdictions, the eCR team, which includes the Association of Public Health Laboratories (APHL), the Council of State and Territorial Epidemiologists (CSTE), and CDC, jumped quickly into action. Under the direction of CDC’s Center for Surveillance, Epidemiology, and Laboratory Services, a nationwide scaleup of eCR supported healthcare facilities to rapidly implement eCR for COVID-19. To further assist the effort, the eCR team developed and introduced the eCR Now Fast Healthcare Interoperability Resources (FHIR) app to allow EHR vendors without eCR capabilities to send case reports for COVID-19.

Progress that was originally slated to take place over a period of years was achieved in months. In less than 12 months, the nationwide scale up helped thousands of healthcare facilities implement eCR and send millions of COVID-19 case reports to public health agencies.

“Our implementation of eCR improved the quality and timeliness of public health reporting for COVID-19 across the 19 states we serve. This national gateway was a cost-effective solution that helped close critical data gaps in wide-scale reporting that saved frontline providers valuable time and money,” said Paul Matthews, Chief Technology Officer, OCHIN.

As the momentum for nationwide use of eCR continues to grow, healthcare providers can now implement and expand eCR for over 100 reportable diseases and conditions. Examples include sexually transmitted infections, foodborne illnesses (e.g., salmonellosis), and noninfectious conditions (e.g., Parkinson’s Disease).

Data transmitted in electronic case reports to state, tribal, local, and territorial health departments support submission of case-based data (without identifiable information) to CDC through the Nationally Notifiable Diseases Surveillance System, which is vital for nationwide public health surveillance. The eCR team will continue to support state, tribal, local, and territorial eCR scale up and data integration into systems. Additionally, the eCR team continues to work collaboratively with external partners to increase EHR vendor engagement and onboard healthcare facilities across the country throughout implementation and expanding to cover all conditions.

Improved data surveillance today helps to prepare us for the public health needs of tomorrow. To learn more or get started, visit the eCR website or contact CDC’s eCR team at