EHR Implementers

EHR Implementers - Readiness and Implementation Checklist

These checklist items outline the actions EHR implementers must take to enable the eCR workflow. Contact the eCR Team via the eCR service desk with any questions. 

• EHR Readiness 
• Communicating Intent  
• Planning Connectivity 
• EHR Product Onboarding and Testing
• Triggering 
• Updating Trigger Codes
• EHR Production

√ EHR Readiness

• Electronic health record (EHR) readiness involves elements related to your EHR software, its implementation in the specific healthcare setting, the ability to send the electronic initial case report (eICR), and the ability to receive and process a Reportability Response (RR) coming back.

• Use of the Electronic Reporting and Surveillance Distribution (eRSD) (including Reportable Conditions Trigger Codes (RCTC)) from public health will guide the EHR when and how to send reports. (For more technical information on triggering, visit the EHR Implementers - EHR Triggering page or visit the eRSD site (external site).)

• The EHR needs to be able to trigger the transmission of eICRs. (For more technical information on triggering, visit the EHR Implementers - EHR Triggering and EHR Implementers - Test Package and Resources pages.)

• The EHR should be able to create the all-condition, all-jurisdiction eICR in accordance with the standard. (For more technical information on the eICR, visit the EHR Implementers - eICR Creation, Validation, & Standards and EHR Implementers - Test Package and Resources pages.)

• The EHR should be able to receive and process a RR for each eICR that you send. (For more technical information on the RR, visit the EHR Implementers - Reportability Response Receipt & Use and EHR Implementers - Test Package and Resources pages.)

• The EHR should adhere to the outlined eCR Requirements (file download).

√ Communicating Intent 

As an EHR company, when you are moving forward with implementing electronic case reporting (eCR) capabilities for your customers, the eCR Support Team will work with you to complete EHR onboarding and testing. Please communicate your intent with the eCR Support Team by contacting the team via the eCR service desk. This will allow us to assist you in testing and onboarding.

√ Planning Connectivity

EHRs should consider technical connectivity during the implementation of their eCR capabilities. Connectivity with the Association of Public Health Laboratories (APHL) Informatics Messaging Services (AIMS) platform can occur using Direct Secure Messaging or XDR through the eHealth Exchange HUB, and/or through a Health Information Exchange (HIE) and Health Information Networks (HIN). Which approach is used may depend on policy and membership status. (For more technical information on connectivity, visit the EHR Implementers - eCR Exchange and Transport and EHR Implementers - Test Package and Resources pages.)

√ EHR Product Onboarding and Testing

To begin testing your eCR capabilities, please complete both test packages below and utilize the test data outlined in the scenarios. This also includes following the suggested patient and clinical site addresses within the scenarios to make sure your test messages are running against the correct public health agency rules. The eCR team will also assist and conduct a visual inspection of the test messages.

This testing should be completed for each EHR product, prior to engaging providers. This would include automated validation as well as visual inspection of the test messages. We suggest starting with the eCR for COVID-19 test scenarios below. 

1. COVID-19 Test Scenarios (download link). 

2. AIMS Online Validator - Run your test eICRs through the AIMS Online Validator (external link) (no PII should be used with this tool). This tool will help identify issues with the messages. We can also help with interpreting the results, and work with you to resolve any schema violations, Schematron severe warnings, and Schematron errors.

3. Please email eCR-Info@aimsplatform.org and put “EHR Content Review” in the subject line.

4. In the email, include the eICR and RR XMLs labeled for each test scenario in a zip file.

5. After reviewing, the eCR Team will follow up with feedback that may require revisions, content modifications, and retesting.

√ Triggering

There is triggering guidance available that is important to follow so your customers meet state and jurisdiction laws for case report timing and completeness.  This guidance can be found on the EHR Implementers - EHR Triggering page. If you need support in supporting each type of trigger, please communicate with the eCR Team via the eCR service desk. 

√ Updating Trigger Codes

Because trigger codes can change regularly, we would like to understand how your EHR product will ensure these will be updated by, or for, your customers regularly. Trigger codes are available through the Electronic Reporting and Surveillance Distribution (eRSD).

Once you have established an account with the eRSD, you will be able to subscribe at no cost to the eRSD service to receive notification and distribution of routine and emergent updates.
 

√ EHR Production

During EHR onboarding, the eCR Support Team will work with you on initial testing of your EHR product(s) prior to engaging with providers. This will include automated validation and visual inspection of the test messages. 

Items to consider prior to engaging providers.

1. Technical connection with AIMS

2. Known onboarding issues

3. Triggering guidance so your customers meet state laws for case reporting

4. Updating the trigger codes through the eRSD for COVID-19

5. Bidirectional information exchange and the RR

Confirming the policy path for each implementing healthcare organization

When you are ready to onboard, submit a help desk ticket to the eCR Team via the eCR service desk.