EHR Implementers

EHR Implementers - Reportability Response Receipt & Use

What is a Reportability Response? What is in it? 

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). It was developed to allow for communication back to healthcare from public health about the following information:

  • The reportability status of conditions identified in an electronic initial case report (eICR)

  • If there are reportable conditions, the jurisdiction(s) reported to along with contact information for them

  • Information about these conditions in the jurisdiction

  • Necessary follow-up testing or condition management information 

  • Other relevant information (e.g., treatment guidelines, fact sheets)

The RR is a companion standard to the eICR and is designed to have one RR created for each eICR. The clinical care organization that created the eICR should receive one RR back. While the RR will also be shared with public health agencies (PHA) if they wish to receive it, the primary audience for the RR is the healthcare provider/reporter in order to communicate information on the status of reportable conditions with succinct next steps they may need to take relative to these conditions and their patients. The CDA Reportability Response Implementation Guide was published in January 2018.

What should clinical care do with the RR upon receipt?

  • For Healthcare Providers: 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:

    • RR is attached to the patient chart.

    • RR is placed in the appropriate healthcare provider/support staff work queue or is communicated to them through some other internal electronic health record (EHR) communications.

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

  • For EHR System Administrators: EHR system administrators should be able to access all returned RRs in order to perform the following tasks (guided by the eICR processing status):

    • To confirm eICRs were successfully submitted and processed

    • To see RR warnings when the eICR was processed, but still needs action:

      • Old/deprecated code is in use and should be addressed.

      • Old version of Electronic Reporting and Surveillance Distribution (eRSD), including the Reportable Conditions Trigger Codes (RCTC), is in use and should be updated .

      • To see RR errors that indicate that an eICR was not successfully processed:

        • To see a full list of errors, see Volume 1 page 14 in the RR Implementation Guide.

Creation and management of eCR standards 

The eICR and RR were developed through the HL7 consensus-based standard development process. Participation included stakeholders from across the industry (clinical care, public health, EHR vendors). We encourage participation in the HL7 process for these standards in the HL7 Public Health Workgroup (external link)

Comments specifically on the eICR STU Implementation Guide can be made on the HL7 STU Comments site for the eICR (external link)

Comments specifically on the Reportability Response STU Implementation guide can be made on the HL7 STU Comments site for the Reportability Response (external link).

Other standards for eCR

While the CDA eICR and RR documents are currently the only eCR standards available for use in production, there are ongoing efforts to expand into Fast Healthcare Interoperability Resources (FHIR). An eCR FHIR Implementation Guide has been balloted and will soon be published. If your organization is interested in prototyping FHIR standards or participating in FHIR Connectathons for eCR, contact us at eCR-Info@aimsplatform.org.