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CALIFORNIA REPORTABLE DISEASE INFORMATION EXCHANGE

  General Frequently Asked Questions (FAQs)

1. How does electronic case reporting (eCR) work? ​

  1.  A provider’s electronic health record (EHR) system generates an electronic initial case report (eICR) based on nationally consistent trigger codes embedded within the EHR. 
  2. The Reportable Conditions Knowledge Management System (RCKMS), operated via the APHL Informatics Messaging Service (AIMS) platform, validates the incoming electronic initial case report (eICR) to determine reportability based on jurisdiction-specific rules. If the eICR is reportable, AIMS transports the message to the public health agency.
  3. Additional technical resources and information can be found at the Centralized eCR Webpage.

2. What is the difference between electronic lab reporting (ELR) and electronic case reporting (eCR)?

  1. Electronic Lab Reporting (ELR) is the electronic transmission of reportable lab result data directly from the laboratory information system (LIS) to the CalREDIE system. 
  2. Electronic Case Reporting (eCR) is the automatic generation of an initial case report from a provider's electronic health record (EHR) system and transmitted to local and state health authorities for review and action. 
  3. Electronic case reporting (eCR) does not replace electronic lab reporting (ELR). Communicable disease reporting under Title 17 Section 2500 governs a healthcare provider’s requirement to report, which may be satisfied by reporting via eCR, and Title 17 Section 2505 governs laboratory requirements to report which may be satisfied via ELR. 

3. What is the difference between electronic case reporting (eCR) and electronic initial case report (eICR)?

  1. Electronic case reporting (eCR) refers to the process of sending a standardized, electronic case report from healthcare providers to public health agencies. An electronic initial case report (eICR) refers to the actual electronic message being sent through the eCR process. 

4. How does eCR benefit healthcare providers?

  1. The automated process of electronic case reporting (eCR) eliminates the need for manual data entry, standardizes what to report when and how to report it, and meets the Title 17 Section 2500 requirement for provider reporting. (More detailed information outlining the benefits of eCR can be found in eCR Informational Bulletin Issue 19. No 5

5. How does eCR benefit public health agencies? 

  1. Electronic case reporting (eCR) provides more complete, accurate, and timely reporting of communicable disease incidents resulting in improved surveillance data.


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FAQs for Healthcare Organizations & Providers

 

1. How can I begin preparing implementation of eCR at my facility?

  1. Check the CalREDIE eCR Informational Webpage for information and updates.
  2. Review the technical resources and information regarding trust and legal connectivity at the Centralized eCR Webpage.
  3. Determine your facility's EHR system readiness to generate an electronic initial case report (eICR) in accordance with the HL7 CDA® R2 Implementation Guide: Public Health Case Report, Release 2 - US Realm - the Electronic Initial Case Report (eICR) published standard.
    1. Reach out to your in-house EHR or IT analyst to confirm your EHR readiness.
    2. Contact your EHR vendor or representative directly to confirm your EHR readiness.
    3. Consider implementing the eCR NOW FHIR app. More information can be found on the Centralized eCR Webpage.
  4. If your EHR system will have the capacity to conform to the HL7 CDA R2 Implementation Guide for eICR standard as listed above, REGISTER for the CalREDIE Electronic Case Reporting program at the CalREDIE eCR Registration Portal or contact your local health jurisdiction representative.
2. How do I register for CalREDIE eCR?
  1. Register through the CalREDIE eCR Registration Portal. As of January 2021, eCR registration is no longer processed through the CDPH HIE Gateway.
  2. Plase note that Los Angeles, San Diego, and Solano counties have selected a local solution for receiving electronic initial case reports (eICRs). For healthcare facilities located in these jurisdictions, please contact the local health department for instructions on how to register for eCR.

3. What information is required to register for CalREDIE eCR?

  1. Healthcare Organization NPI Number:  Registration for eCR is based on the healthcare facility and not intended to register individual providers.
    1. Healthcare organizations with multiple locations may register one or more locations using the National Provider Identifier (NPI) for the organization.
  2. Electronic Health Record (EHR) system vendor: i.e. Epic, Cerner, Allscripts, Meditech, eClinicalWorks, etc.
    1. EHR Product Name and version are requested but not required.
  3. Is your EHR system capable of generating an electronic initial case report (eICR)? (Yes/No/Unknown)
  4. Current method of submission for organization’s reportable disease incidents: (CalREDIE/CMR fax/Other)

4. What happens after I register for CalREDIE eCR?

  1. All providers are required to continue reporting to their local health department using their current method until explicitly notified by CalREDIE that they have been approved to report via eCR alone.

  2. CalREDIE will review your facility’s registration form and contact the name provided to verify eCR enrollment and onboarding readiness.

  3. Healthcare providers will be prioritized and queued based on organizational reporting volume and organizations using Certified Electronic Health Record Technology (CEHRT)with the capability of sending eICR messages per the HL7 guidelines. 

5. Does CalREDIE provide attestation documentation for the Promoting Interoperability (previously Meaningful Use) measure requiring active engagement with a Public Health Agency (PHA)? 


The attestation documentation provided by CalREDIE requires your organization to follow these steps:

i. Step 1: Determine your facility’s EHR system readiness to generate an electronic initial case report (eICR) in accordance with the HL7 CDA® R2 Implementation Guide: Public Health Case Report, Release 2 - US Realm - the Electronic Initial Case Report (eICR) published standard.

a. *This is a CRITICAL step in determining your facility’s eligibility to enroll in the CalREDIE eCR Program. Please note that it is not the expectation that your EHR system is ready to send and receive eICR right now in accordance with the HL7 CDA R2 Implementation Guide for eICR standard, but instead that your EHR system will be capable to do so before completing the eCR Onboarding process. 

ii. Step 2: Register your facility’s intent to submit electronic initial case reports (eICR) via CEHRT by registering at the CalREDIE eCR Registration Portal. 

a. Save ALL subsequent e-mail correspondence from the CalREDIE eCR Registration Portal/ CalREDIE Team involving the registration and onboarding process.

b. As capacity continues to be built for sending and receiving eCR, the types of documentation required to attest for Promoting Interoperability may change. Continue to check back on this website for updates.

6. How is electronic case reporting (eCR) different than reporting through the Provider Portal? 
  1. In many ways, eCR will operate like an “automated Provider Portal.” Rather than the provider manually entering patient and case data into the Provider Portal, an electronic initial case report (eICR) will be automatically generated from the provider’s electronic health record (EHR) system. The eICR will then be sent to CalREDIE where local health departments (LHDs) can review, assign and process those reports as appropriate.

7. What is the role of the Association of Public Health Laboratories (APHL) Informatics Messaging Service (AIMS) in electronic case reporting?

  1. AIMS is a secure cloud-based environment that accelerates the implementation of health messaging by providing shared services to aid in the transport, validation, translation, transformation, and routing of electronic data.
  2. AIMS is the centralized platform used to scale electronic case reporting (eCR) nationwide via a shared services platform, a common set of rules, and interoperability between systems.
  3. eCR can be implemented through a direct connection from the healthcare organization to the AIMS platform. However, that single point of connection needs Health Insurance Portability and Accountability Act (HIPAA) business associate authorities to help support the organization in appropriate reporting to all required public health agencies. Please see the Centralized eCR Webpage under Healthcare Providers for information on trust and legal connectivity.  

8. What is the role of Health Information Exchanges (HIEs) and Health Information Networks (HINs) in eCR?

  1. Health Information Exchanges (HIEs) and Health Information Networks (HINs) are important partners for electronic case reporting (eCR). They can support policy and technical scalability for eCR to help enable the many-to-many connections needed between clinical care organizations and public health agencies.
  2. Review HIEs & HINs role in eCR at the Centralized eCR Webpage.

Please note, timely reporting via phone call is still required for conditions marked as "immediately" reportable in Title 17, Section 2500 of the California Code of Regulations (CCR). Healthcare organizations onboarding to eCR are required to continue sending COVID-19 case reports via their current method of reporting until explicitly notified by CalREDIE that the organization has been approved to send electronic initial case reports in lieu of a paper report for COVID-19.

 

FAQs for Local Health Jurisdictions

1. Will an electronic initial case report (eICR) go into the CalREDIE Disease Incident Staging Area (DISA)?

  1. Yes. The electronic initial case report (eICR) will go to the DISA where local health departments (LHDs) can review, assign and process those reports as appropriate. We are anticipating eCR to operate as an "automated Provider Portal."
  2. A snapshot of the original eICR message may be found in the Electronic Filing Cabinet (EFC) of the patient's record.

2. Will eCR replace ELR?

  1. No. Electronic case reporting (eCR) does not replace electronic lab reporting (ELR). An electronic initial case report (eICR) is a complement to the ELR.
  2. Communicable disease reporting under Title 17 Section 2500 governs a healthcare provider's requirement to report, which may be satisfied by reporting via eCR, and Title 17 Section 2505 governs laboratory requirements to report which may be satisfied via ELR.

3. What is the difference between electronic lab reporting (ELR) and electronic case reporting (eCR)?

  1. Electronic Lab Reporting (ELR) is the electronic transmission of reportable lab result data directly from the laboratory information system (LIS) to the CalREDIE system.
  2. Electronic Case Reporting (eCR) is the automatic generation of an initial case report from a provider's electronic health record (EHR) system and transmitted to local and state health authorities for review and action.
  3. Electronic case reporting (eCR) does not replace electronic lab reporting (ELR). Communicable disease reporting under Title 17 Section 2500 governs a healthcare provider's requirement to report, which may be satisfied by reporting via eCR, and Title 17 Section 2505 governs laboratory requirements to report which may be satisfied via ELR. 

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