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.

For Healthcare Organizations

Step 1: Prepare for eCR Adoption

These EHR/Health IT products are ready for general healthcare organization onboarding:

  • Altera Sunrise
  • athenahealth athenaOne (athenaClinicals and athenaHHS)
  • Epic
  • Flatiron OncoEMR
  • Medhost eCR 1.0
  • Meditech Expanse
  • Oracle Cerner Ambulatory
  • Oracle Cerner Millennium
  • Oracle Cerner CommunityWorks
  • Premier Inc. TheraDoc
  • Veradigm – Veradigm EHR
  • If your HCO uses one of the EHR/Health IT products above, email your vendor 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

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.
For EHR Vendors

For more information:

EHR Implementers Checklist (APHL)

Step 1: Contact APHL

Step 2: Build Capabilities and Connect

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.
For Public Health Agencies

Step 1: Ensure Connectivity

Step 2: Author in RCKMS

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

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 to request recruitment materials and get assistance with outreach.