Getting Started with eCR

Key points

  • 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, public health partners and state, tribal, local, and territorial PHAs are all essential in implementing eCR.
A board game with playing pieces in the Start position


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 eCR implementers. This page outlines the eCR implementation process for healthcare organizations, EHR vendors, and public health agencies.

For healthcare organizations

Step 1: Prepare for eCR adoption

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

These EHR/Health IT products are ready for general healthcare oganization 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

  • When 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.
  • 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(s) for production data validation and quality review.
  • Discontinue manual reporting once your PHA(s) confirm you can do so.

For EHR vendors

Step 1: Contact APHL

For more information:‎

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

  • Contact HCOs that use your EHR products and help them implement eCR.

Public Health Agencies

Step 1: Confirm completion of eCR prerequisites

  • Ensure you or an affiliated PHA have the appropriate laws or codes for reportable conditions in place for your jurisdiction's providers.
  • Publish and maintain the list of reportable conditions where it can be accessed by healthcare organizations or providers, such as a public-facing website.
  • Determine if you wish to receive eCR data directly or in collaboration with an affiliated PHA.
  • Email to connect with the CDC eCR PHA Support Team.

Step 2: Establish connectivity for eCR

  • Establish a connection between you or an affiliated public health agency and AIMS, the APHL Informatics Messaging Services platform, to receive electronic case reports.
  • Determine if another trusted entity will receive the data on behalf of your PHA and submit a letter of attestation as needed.

Step 3: Author in the Reportable Conditions Knowledge Management System (RCKMS)

  • Enter your jurisdiction's reporting criteria for reportable conditions into the RCKMS. There are currently more than 200 conditions available for authoring.
  • Update your reporting criteria during outbreaks or when new versions are available.

Step 4: Use electronic case reports

Step 5: Communicate with HCOs

  • Engage with the eCR team and local HCOs and facilities to implement eCR. These can be any organizations that are required to carry out provider case reporting for reportable diseases and conditions, including large organizations, federally qualified health centers, or organizations that work with underserved populations.
  • Contact to request HCO engagement materials and get assistance with outreach.