Public Health Agencies

The following activities for PHAs need to be undertaken to prepare for eCR

√ Author in RCKMS 

In order for the Reportable Conditions Knowledge Management (RCKMS) to fully adjudicate Electronic Initial Case Reports (eICRs) each Public Health Agency (PHA) needs to author their jurisdictional reporting specifications in RCKMS.  The RCKMS decision support service will compare the data in the eICR to the jurisdiction specifications to determine the reportability of the eICR. 

Currently RCKMS is open for authoring for the following conditions: Chlamydia, Gonorrhea, Hepatitis C, Pertussis, Zika, Parkinson’s Disease and 14 Enteric conditions. Authoring is open continuously; however, dedicated office hours for discussion of specific condition specifications are offered during predetermined periods. More information about access, authoring, and timelines of these conditions can be found here on the RCKMS website.

A content release schedule for additional conditions to be authored can be downloaded here.  Default content (value sets, criteria, and logic sets) has been developed for 74 notifiable conditions and can be viewed by visiting the RCKMS Content Repository page

√ Establish initial connectivity with AIMS for receipt of eICRs/RRs outside jurisdiction

Test and use the existing connection with the Association of Public Health Laboratories (APHL) Informatics Messaging Services (AIMS) platform to receive eICRs and copies of Reportability Responses (RRs) documents from the AIMS platform for reporters outside of your jurisdictions. The initial use of this eCR connection will only be for the very limited cases where patients who reside in your jurisdiction receive care elsewhere and have a condition that is reportable to you.

√ Visualize eICRs and RRs as an interim solution for out of jurisdiction reports

Until your surveillance system has the capability to consume and process the eICRs, these documents can be visualized as HTML for use by surveillance personnel.  

If your PHA needs assistance with this initial connectivity or visualization please contact the eCR Support Team at: informatics.support@aphl.org  - please include “eCR” in the subject line to enable a faster response.

√ Determine readiness and build capacity in Infrastructure/Surveillance system(s) for eICRs and RRs

The first step will be to determine the capabilities of your technical infrastructure/surveillance system(s) to consume and use eICRs and RRs.  If capabilities do not exist, PHAs should define a plan for upgrading/building in eCR capabilities.

If eCR functionality exists within your technical infrastructure/surveillance system(s), it will be best to first determine a workflow approach for receipt and processing of eICRs into your surveillance system(s).  See more details about testing and implementation on the Onboarding and Implementation page.

√ Declare readiness for eCR onboarding with healthcare providers within the PHA jurisdiction

PHA should declare readiness for eCR as a Public Health Reporting option (typically on the PHA website) for the CMS Promoting Interoperability (PI) programs.  This is where healthcare providers would “register their intent” to carry out eCR. Similar to other public health reporting objectives, PHAs may choose to place those that have registered in a queue for onboarding but allow them to receive credit for active engagement in PI.