EHR Implementers

EHR Implementers - Reportability Response Receipt & Use

Overview

The Reportability Response (RR) is a consensus-based Health Level Seven International (HL7) standard developed for use in electronic case reporting (eCR) based on the HL7 Clinical Document Architecture (CDA). 

The RR is a companion document to the electronic initial case report (eICR), designed to pair one RR created for each eICR. It was developed to allow for communication back to healthcare organizations (HCOs) from public health. Additionally, it confirms the receipt and processing of eICRs. The sending HCO that created and transmitted the eICR should receive one RR back in return.

Information Included in a RR

The RR communicates information on the status of reported conditions with succinct next steps the healthcare provider/reporter may need to take relative to these conditions and their patients.

It includes the following information:

• The reportability status of conditions identified in an eICR.
• If there are reportable conditions, the jurisdiction(s) that were reported to, along with contact information for the public health agencies (PHAs).
• Information about reported conditions in the jurisdiction.
• Necessary follow-up testing or condition management information, including suggested or required clinical follow-up activities from the responsible PHA(s), including any additional reporting needs or infection control activities.
• Other relevant information such as clinical support resources suggested by the responsible PHA(s) for identified reportable conditions (e.g., treatment guidelines, fact sheets).

RR Standards[1] and Formatting

The CDA RR R1.1 (HL7 CDA® R2 Implementation Guide: Reportability Response, Release 1, STU Release 1.1 - US Realm), available for download on the HL7 website (external link), was published in January 2018.

Additional XML support files (such as example files, stylesheets, and the Schematron validation files) can be downloaded by clicking the green code button at this GitHub link (external link). There is a specific stylesheet to illustrate the desired format of the rendered RR CDA document.

RR Use

When an RR contains conditions that are “reportable” or “may be reportable,” the healthcare provider and/or appropriate support staff should be notified by one of the following methods:

• The RR is attached to the patient chart.
• The RR is placed in the appropriate healthcare provider/support staff work queue or is communicated to providers through another internal electronic health record (EHR) communication method.

In general, “reportable” and “may be reportable” communications require healthcare provider or healthcare provider staff attention, but do not need “alerting” and workflow disruption.

More information on determination of reportability can be found in CDA RR R1.1: Volume 1 — Introductory Material, pages 11-12.

EHR system administrators should be able to access all returned RRs to perform the following tasks related to eICRs that were not processed or eICRs that were processed but contain issues (as designated by the eICR Processing Status):

• View any RR “warnings” when the eICR was processed that still needs action. 
  • RR “warnings” indicate that the eICR was received and processed, but that there is an issue to be addressed by an EHR administrator. Warnings may include that the EHR is using an outdated version of the eRSD and trigger codes, or that a minor issue exists in the relevant eICR.
• View any RR errors that indicate an eICR was not successfully processed.
  • For RR “errors,” the EHR administrator needs to determine what caused the issue (the validation error details are available in the RR to help diagnose the problem), and that the provider of care may need to be notified that required reporting has not been done.

A full list of eICR Processing Status values can be found in CDA RR R1.1: Volume 1 — Introductory Material, page 14.

Other standards for eCR

See the eICR Creation, Validation, and Standards page for information on other standards for eCR.