Electronic Case Reporting (eCR)

Electronic Case Reporting (eCR) is the secure creation and transmission of case reports from an electronic health record (EHR) to public health agencies for disease surveillance, case management, and contact tracing. The use of eCR will enable healthcare providers to fulfill their mandated reporting requirements to Los Angeles County Department of Public Health (LAC DPH) and report cases for further investigation from their EHR faster, more accurately, and more reliably than traditional manual reporting.

LAC DPH uses the HL7 electronic initial case report (eICR) standards (R1.1 and R3) for electronic case reporting (eCR) and to support the new CMS Promoting Interoperability regulations for eCR. It is these standards that we will use to eventually eliminate manual reporting requirements. We also require the use of APHL AIMS and the Reportable Condition Knowledge Management System (RCKMS) to ensure appropriate reporting.

Participation

Healthcare organizations operating in Los Angeles County as well as those providing care to Los Angeles County residents may register with LAC DPH to submit eCR data.

Participation in eCR allows eligible professionals, eligible hospitals, and critical access hospitals to satisfy the Center for Medicare and Medicaid Services (CMS) regulatory requirements of the Public Health and Clinical Data Exchange objective for the Promoting Interoperability (PI) Program and the Merit-based Incentive Payment System (MIPS). (PDF) Eligible hospitals for PI are defined as acute care hospitals (including CAHs and cancer hospitals) with at least a 10 percent Medicaid patient volume, and children’s hospitals (no Medicaid patient volume requirements). For more information on Promoting Interoperability in LA County .

REGISTER HERE

Steps for Participation

Step 1: Preparation

• Validate that your EHR is on the Certified IT Products list and has worked with APHL eCR team to test eCR product.
• Determine if your EHR can generate HL7 CDA R2.

Step 2: Communication

• Communicate intent to participate in eCR by registering with LAC DPH by completing this form.
• LAC DPH will connect you with the CDC eCR team to initiate technical onboarding with APHL Integrated Messaging Service (AIMS) and your EHR vendor. You may also email them directly at ecr@cdc.gov and copy the LAC DPH team at ecr@ph.lacounty.gov.

Step 3: Connection

• Work with your EHR vendor and the AIMS team to implement a connection to the AIMS hub.
• If you have any questions, please email the AIMS eCR Support Team .
• Verify that your EHR is registered to the Electronic Reporting and Surveillance Distribution to guide triggering and reporting of reportable conditions.

Step 4: Testing and Validation

• Once connection has been established, you will enter a ‘testing and validation’ status during which your eCR data will undergo basic testing and validation by AIMS and further PHA testing and validation by LAC DPH.

Step 5: Production Environment Go-live

• Once readiness and implementation steps have been completed you will be ready to go into production.

Important Notes

• Do not discontinue your existing reporting method for electronic case reported conditions (e.g., web-reporting, faxing reports to your local public health authority) until you receive official notification from LAC DPH authorizing this action. This authorization will be issued after all testing and validation processes are completed.
• Some conditions may not be immediately available to be reported via eCR. Your organization will still be responsible for submitting those conditions manually until approved otherwise.
• If you need attestation documentation to validate meeting CMS requirements, email eCR@ph.lacounty.gov.

FAQs

Is reporting via eCR required?

• While currently not mandated by California law, it is required for PI and MIP electronic case measures and for Public Health and Clinical Data Exchange.
• Recently, there has been regulatory changes to the Office of the National Coordinator for Health Information Technology (ONC) Certification Program for electronic case reporting to public health authorities.
  • For more information, refer to the eCR Certification Criterion Enforcement Discretion Notice

How does eCR differ from electronic lab reporting (ELR)?

ELR is the electronic transmission of lab reports to public health for identification of notifiable conditions, while eCR is the automatic generation of an initial case report sent directly from the provider’s EHR system to public health. Please note that eCR is not intended to substitute any ELR requirements.

HL7 CDA R1.1 or CDA R3 implementation