Healthcare Providers

√    EHR Readiness

EHR readiness involves: (1) elements related to your electronic health record (EHR) software and vendor, (2) the EHR implementation in your particular healthcare setting, (3) the ability to send the Electronic Initial Case Report (eICR), and (4) the ability to receive a Reportability Response (RR) back.

√    Communicating Intent

When you are moving forward with eCR, you will need to communicate your intent to participate to your state PHA as well as communicate with the eCR Support Team via the eCR general information desk Not all PHAs are fully ready to implement eCR, but if your PHA has declared readiness you should register your intent with that PHA and be able to attest for eCR in the CMS Promoting Interoperability program.

√    Planning Connectivity

There are two major elements of connecting your clinical care site to public health for eCR - policy / trust agreements and technical exchange. The two elements are interrelated, but also require different staff to effectuate.

  1. Trust and Legal Connectivity

  • eCR has created a single point of connection that can be used for reporting, but that single point of connection needs HIPAA Business Associate authorities to help support your organization in appropriate reporting to all required Public Health Agencies (PHAs) (for more information please visit the eCR Data Sharing Policy page). There are two ways to implement the necessary data sharing agreements:
    • Have your organization sign an agreement with APHL that was designed for this purpose. This agreement can be found here.

    • Or, use the agreements that are in place for up-to-date participants in the eHealth Exchange health information network. If your organization is a member directly or through a representative, like an HIE, and you are current with membership agreements, you should already be able to participate without needing any other agreements or signatures.

  • A list of current eHealth Exchange Participants can be found here. If your organization is not already a member of the eHealth Exchange somehow, the eHealth Exchange is offering no charge memberships for eCR only participants. More information on all of these possibilities available on this site under the HIEs and HINs page and you can also contact the eCR general information desk at

  2. Technical Connectivity

  • eCR can be implemented through a direct connection from your healthcare organization to the AIMS platform or through most Health Information Exchanges (HIEs) and Health Information Networks (HINs). The technical specifics of your reporting will be dependent on the Trust and Legal Connectivity approach you choose above. (For more technical information on connectivity, please visit the EHR Implementer - eCR Exchange and Transport page)

Help for both of these steps can be received by connecting with the eCR general information desk at

√    Onboarding and Production

When the previous readiness and implementation steps have been completed and the EHR Implementer supporting details for them are in place, you are ready to go into production. There are technical materials including support for triggering, eICR creation, RR receipt, and technical readiness testing available on the EHR Implementers section of this website.

The technical details in the EHR Implementers section of this website provides the specific details necessary to move into production.

When you are ready to onboard, please submit a helpdesk ticket with the eCR Support Team by emailing and include “eCR” in the subject line to ensure proper triage and routing.

Please contact the eCR general information desk with any questions that you may have about the process.