Public Health Agencies - Onboarding and Implementation
Onboarding communications between PHA and eCR Support Team
The Healthcare Providers - Readiness and Implementation Checklist indicates that a healthcare provider should register their intent with public health agencies (PHA) and then notify the eCR Support Team about their readiness.
We recognize there may be scenarios where the eCR Support Team might hear about a healthcare provider ready to do eCR without having contacted their PHA first. In such cases, the eCR Support Team will connect with the PHA to determine readiness and appropriate next steps.
As more healthcare providers reach out about readiness to start electronic case reporting (eCR), there will be a need to queue these healthcare providers as the eCR Support Team works with the appropriate PHA to prioritize the order in which onboarding will occur.
Other considerations for surveillance system(s) capabilities
If there are multiple surveillance systems at play (where different surveillance systems are used for different conditions groups (e.g., foodborne, zoonotic, etc.)), you will need to determine the condition being reported to your jurisdiction. The Reportability Response (RR) identifies the condition(s) that were determined reportable for the associated electronic initial case report (eICR) and can be used to support the routing of the incoming eICR to the applicable surveillance system(s)/program(s).
PHAs will need to assess and determine what environments will be used to implement eCR. The PHA will have both a test and a production channel with the Association of Public Health Laboratories (APHL) Informatics Messaging Services (AIMS). The test channel will be used for non-personally identifiable data (PII) data. PII data would only ever be received through the production channel.
During your eCR planning activities, all stakeholders at the PHA (i.e., IT, informatics, epidemiologists) should agree upon which technical environments/infrastructure (test, staging, production, etc.) within the PHA will be used for each data feed coming from AIMS (testing and production). Special attention should be given to determining which environments will be used when production data (i.e., eICRs and RRs) start flowing from electronic health records (EHRs) because they will have PII. Some PHAs may want to route production data first into the PHA test environment; some may not. The determination and execution of this routing needs to be determined by the PHA.
In addition to receiving and consuming eICRs and RRs, systems should also be able to deduplicate records, update records if an additional related eICR comes in at a later point in time, and match eCR reports with any incoming electronic laboratory reports.
Finalize production connectivity with AIMS for in-jurisdiction reporters
PHAs may need to work with AIMS to determine if the current AIMS connection being used to receive out-of-jurisdiction case reports has sufficient bandwidth to receive the increased volume that will occur with in-jurisdiction production case reports. If a different connection is desired, submit a helpdesk ticket with the eCR Support Team by emailing Informatics.Support@aphl.org and include “eCR” in the subject line to ensure proper triage and routing.