×

To enhance security, Multi-Factor Authentication (MFA) is mandatory for all HL7 users. More information

 
Return to Search

FHIR Electronic Case Reporting (eCR)

Return to Search

Basics

FHIR Electronic Case Reporting (eCR)

1366
Ballot - STU to Normative


FHIR Implementation Guide; FHIR Profile

Revise Current Standard

Details

Public Health electronic case reporting (eCR) is the principally automated, bidirectional exchange of information between clinical care and public health in the context of reportable conditions.

This project will build off of the C-CDA STU Public Health Case Report standards to support a number of activities related to electronic case reporting (eCR) through appropriate FHIR representations:

1. Reporting, investigation, and management - electronic transmission of clinical data from Electronic Health Records to Public Health - including; 1) the existing electronic initial case report (eICR) version 1.1, 2) new eICR data from all EHRs, 3) pushed and pulled, non-eICR, condition specific EHR data, and 4) supplemental data not found in EHRs. The management and processing of population cases including potentially a FHIR population case resource.

2. Bi-directional information exchange - the response to the eICR including the delivery of relevant public health information in the context of the patient and their possible relevant conditions - including the Reportability Response transaction

3. Triggering and decision support - the automated initiation of an initial report in Electronic Health Records based on public health specifications and logic as well as clinical care factors. The specification of simple logic 'triggers' and a pathway to more complex logic distribution. Including the workflow tie-in opportunity for contextualized public health information.

As with the initial electronic case report, the project will strive to minimize reporting burden and use data that are established to exist in EHRs as a product of care. It will, whenever possible, use existing FHIR resources so as to constitute data that can be readily produced and delivered by EHRs.

The strategy for development undertaken by this project includes the use of a US Realm Standard for Trial Use (STU) for actual development and deployment. Following the STU period, for a period of two years, a Normative standard will be balloted. It will also include the pursuit of a universal FHIR population case resource and the specification of documents, value sets, extensions and other resources as necessary to support these activities.

Co-chair Sponsor: Erin Holt

Last Review: 2/1/18

Ballot reconciliation ongoing - 2/1/18


With the advent of Electronic Health Records (EHRs), there are tremendous opportunities to support public health surveillance and the delivery of public health information to clinical care. eCR can support more complete and timely possible case data, support disease and condition monitoring and trending, assist outbreak management and suppression, and improve relevant information delivery to clinicians in the context of jurisdictional disease trends and patient specifics.

eCR has an HL7 CDA STU implementation guide (the Electronic Initial Case Report - eICR) for all-jurisdiction, all-condition initial reporting to public health from EHRs. It also has an in-process HL7 CDA STU implementation guide (the “Reportability Response”).

With the advent of FHIR standards, eCR will also need appropriate FHIR resources, transactions, and implementation guidance to support this process. FHIR also offers opportunities to supplement eICR data and improve the ease of implementation and consistency of the automated triggering of eICRs and the decision logic needed to advance both reporting to public health and provision of public health information to clinical care.



Request FHIR Population Case Resource - Target: 2017 Fall Triggering --- For Comment Only Ballot - Target: 2018 Jan Ballot Submit FHIR eCR IG for STU Ballot - Target: No earlier than 2018 May Ballot Complete STU Reconciliation - Target: 2018 Sept WGM Request STU Publication - Target: 2018 Oct STU Period - 24 months - Target: 2018 Nov - 2020 Nov Align supplemental data needs with appropriate FHIR approaches and identify follow-on activities - Target: 2018 Consider STU comments to determine if revised IG should be re-balloted - Target: 2021 Jan Ballot If not, Submit for Normative Ballot (and follow subsequent steps) - Target: 2021 Jan Ballot Complete Normative Reconciliation - Target: 2021 May WGM Submit Publication Request - Target: 2021 June Receive ANSI Approval - Target: 2021 July Project End Date (all objectives have been met) - Target: 2021 Dec


https://confluence.hl7.org/display/PHWG/Public+Health+Case+Reporting http://wiki.hl7.org/index.php?title=PHER_Public_Health_Case_Report_R2 https://github.com/HL7/PH-Case



Regulatory Agency, Standards Development Organizations (SDOs),Local and State Departments of Health; Healthcare Institutions (hospitals, long term care, home care, mental health),EHR, PHR; Health Care IT; Clinical Decision Support Systems

1) One or more vendors - providers of software to senders. Anticipated participation by some of the EHR vendors engaged in implementing eCR with Digital Bridge (Cerner, Epic, Allscripts, Meditech and eClinicalWorks) 2) One or more Public Health Agencies (State/Local Department of Health) - receivers of case reports. Anticipated participation by some of the PHAs engaged in implementing eCR with Digital Bridge. 3) Healthcare organizations – senders of the data to appropriate PHAs. Anticipated participation by some of the Healthcare organizations engaged in implementing eCR with Digital Bridge. 4) Public health decision support implementers - a) Council of State and Territorial Epidemiologists RCKMS project - Confirmed participation 9/21/2017, and b) HLN Consulting - Confirmed participation 9/21/2017. 5) Shared public health services platform - receiver of eCR and host of some decision support tools - Association of Public Health Laboratories AIMS Platform - Confirmed participation 9/1/2017.

Public health has been historically slow in identifying, developing, and implementing standards and has resultantly struggled to advance interoperability. This project will strive to have a path forward for eCR in FHIR to use as soon as the industry is ready to adopt it so as to advance a more interoperable future. Some of the factors driving the need for standards to support electronic case reporting include: 1) Decreasing reporting burden on clinical care 2) Fostering interoperability between the many clinical care sites and the many Public Health Agencies. 3) Meeting Public Health (STLT) Agency and statutory reporting requirements 4) Providing public health and jurisdictional contextualized information to clinical care on patients with reportable conditions 5) Advancing more comparable data to enhance the Nationally Notifiable Diseases Surveillance System (NNDSS)

Electronic Case Reporting (eCR), Electronic initial case report (eICR), Reportability Response, Public Health Case Reporting, Supplemental Data, Trigger Codes, Public Health Reporting, Reportable conditions, Public Health Decision Support, Nationally Notifiable conditions, Decision logic

Will coexist with: 1) HL7 CDA R2 Implementation Guide: Public Health Case Report, Release 2, STU Release 1.1 - US Realm, the Electronic Initial Case Report (eICR) 2) HL7 CDA R2 Implementation Guide: Reportability Response, Release 1, STU Release 1.0 - US Realm

Yes

Don't Know

No

2024 January: TSC approved STU Extension Request for HL7 FHIR Implementation Guide: Electronic Case Reporting (eCR), Release 2.1.1. 2022 August: TSC approved Unballoted STU Update Publication Request for HL7 FHIR Implementation Guide: Electronic Case Reporting (eCR), Release 2.1 2021 December: TSC approved STU Publication Request for HL7 FHIR Implementation Guide: Electronic Case Reporting (eCR), Release 2 2019 Dec: TSC approved STU Publication Request for HL7 FHIR Implementation Guide: Electronic Case Reporting (eCR) - US Realm for 24 months External Vocabularies: LOINC, SNOMED-CT, ICD-10-CM, PHIN Value Sets, FIPS, UCUM, RxNorm, FHIR Resources
Organization & Realm

Realm Specific - Enter "U.S." or name of HL7 Affiliate below

U.S.
People

John Loonsk, eCR Standards Executive Sponsor, CGI Federal and Consultant to APHL



Public Health Work Group

Clinical Information Modeling Initiative Work Group; Clinical Decision Support Work Group; Clinical Quality Information Work Group

Status & Dates

Active

STU - Test Period/Accepting Comments

09/29/2017

01/01/2028

2028 Jan WGM/Ballot

01/15/2027

2027 Jan WGM/Ballot

2026 Jan Ballot Cycle Info: STU. Met basic vote requirements with 15 negatives to reconcile. Ballot name: HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR), Edition 3 - US Realm 2021 Jan Ballot Cycle Info: STU Ballot Results: Did not meet basic vote requirements. 32 Negatives to reconcile Document Name: HL7 FHIR Implementation Guide: Electronic Case Reporting (eCR), Release 2 - US Realm 2018 Oct Ballot Cycle Info: STU Ballot results: Met basic vote requirements. 24 Negatives to reconcile Document Name: HL7 FHIR Implementation Guide: Electronic Case Reporting (eCR) - US Realm, Release 1 2018 Jan Ballot Cycle Info: COMMENT ONLY Ballot results: Did not meet basic vote requirements Document Name: HL7 FHIR Implementation Guide: Electronic Case Reporting (eCR), Release 1
Approvals

11/16/2017


Received


All Received




System Info



View Ballot Items (with NIBs)



04/09/2026

Anne Wizauer
Return to Search