Getting Started with eCR

Electronic case reporting (eCR) is the automated, real-time exchange of case report information between electronic health records (EHRs) and public health agencies (PHAs). Healthcare organizations (HCOs), EHR vendors, and state, tribal, local, and territorial PHAs are all essential in implementing eCR. CDC’s eCR team, in coordination with the Association of Public Health Laboratories (APHL) and the Council of State and Territorial Epidemiologists (CSTE), provides support for implementers and collaborates with them throughout the process. This section provides an outline of the process that HCOs should follow.

Step 1: Prepare for eCR Adoption

• If your HCO uses one of the EHR/Health IT products above, email ecr@cdc.gov to learn more about getting started with eCR.
• Work with the eCR team to connect with your PHA and register your intent for eCR (see Appendix IV – State and Local Public Health Readiness for Interoperability).
• Partner with your EHR/Health IT vendor to discuss options for implementing eCR.
• Get final approval from your organization’s leaders to implement eCR.

Step 2: Implement eCR

• For more information:

  Healthcare Providers: Readiness and Implementation Checklist (APHL)

  As directed by your assigned eCR onboarding coordinator, follow the process here to begin implementation: eCR for Healthcare Providers.

  • Work with your EHR/Health IT vendor to enable eCR functionality and conduct testing.
  • Make sure that your policy path is in place for reporting to PHAs without violating HIPAA or any applicable state laws.
  • Complete the eCR Provider Intake Form when directed to do so by your eCR onboarding coordinator.

Step 3: Go Live

• Work with your eCR onboarding coordinator, EHR/Health IT vendor, and PHA to ensure testing and data quality meet public health requirements.
• Send production messages.
• HCO must maintain current manual case reporting processes alongside eCR until notified otherwise by the relevant PHAs for your organization.

Step 4: PHA Validation

• Collaborate with your PHA for production data validation and quality review.
• The PHA will communicate when you can discontinue manual reporting.

Step 1: Contact APHL

• Email ecr@aimsplatform.org to indicate you are interested in implementing eCR.

Step 2: Build Capabilities and Connect

• Build eCR capabilities or connect to the eCR Now FHIR app (APHL).

Step 3: Test

• Test with a client HCO and make sure that eCR capabilities meet real-world testing standards.

Step 4: Offer eCR to Other HCOs

• Reach out to HCOs that use your EHR products and help them implement eCR.

Step 1: Ensure Connectivity

• Make sure that you or an affiliated public health agency is connected to AIMS, the APHL Informatics Messaging Services platform, to receive electronic case reports.

Step 2: Author in RCKMS

• Enter your jurisdiction’s reporting criteria for reportable conditions into the Reportable Condition Knowledge Management System (RCKMS).
  • There are currently more than 200 conditions available for authoring.
  • Update your reporting criteria during outbreaks or when new versions are available.

Step 3: Use Electronic Case Reports

• Make data available to your public health agency epidemiologists.
• Process and use eCR data in your surveillance system(s).
  • Make a plan and update your surveillance system(s), if needed.
  • Receive technical assistance at ecr@cdc.gov.

Step 4: Communicate with HCOs

• Engage with the eCR team and local HCOs to implement eCR.
  • These can be any organization that is required to carry out reportable condition reporting, including large organizations, federally qualified health centers, or organizations that work with underserved populations.
  • Contact ecr@cdc.gov to request recruitment materials and get assistance with outreach.