What Is eCR? Overview and FAQ

Information exchange between healthcare facilities and public health agencies is essential for monitoring and minimizing the spread of communicable diseases. The use of eCR has helped automate this exchange, expediting the transfer and collection of vital public health data. But what is eCR and how do facilities go about implementing it?

If you’re a facility leader looking to streamline your case reporting process, you may have questions about implementing or upgrading your eCR system. We’ll walk you through the basics of eCR and its importance, and then dive into everything else you need to know about using it at your facility.

What Is eCR?

Medical systems rely heavily on timely and accurate communication of information between organizations to ensure patient safety. This transfer of health information is especially important for public health management, which requires prompt communication between healthcare facilities and public health agencies (for instance, during an outbreak of a disease).

Electronic case reporting, or eCR, is an automated system that allows for real-time transmission of information between electronic health records (EHR) systems and public health agencies. An eCR function is embedded in an EHR system and detects any reportable information that should be sent to agencies for disease surveillance purposes.

How Does eCR Work?

Once a health professional documents patient information in the EHR, the eCR will generate a report if the coded conditions are relevant or required for public health surveillance. If the report meets all legal requirements, it will then be sent to a public health agency for review.

As an example, we can see how eCRs are used to track COVID-19 cases:

• A patient is diagnosed with COVID-19.
• The healthcare provider documents the patient’s information in the EHR.
• The eCR function generates a case report on the patient.
• COVID-19 is classified as a reportable condition, so the report is automatically transferred to the state’s public health agency.
• The public health agency sends confirmation back to the healthcare provider.
• The public health agency reaches out to the patient for contact tracing and vaccination purposes.

The first report of a patient’s condition may be referred to as an electronic initial case report (eICR). Some eICRs don’t meet the state- or territory-specific guidelines for reportable conditions and are therefore not progressed through the system. After the first eCR, report meanings can vary and will be exchanged bidirectionally. For example, responses sent from the public health agency to the provider contain status reports and feedback about the case.

What Is eCR’s Importance?

Now that you understand what an eCR is and how it works, you may be wondering why it matters to your facility. Each state has laws requiring healthcare facilities to report on certain diseases that are relevant to public health surveillance. Historically, healthcare providers had to manually report cases, which proved to be an inefficient and sometimes inaccurate method of capturing large-scale public health data.

Through the automation of eCR, healthcare providers no longer have to worry about sending case-by-case reports. The eCR system has streamlined this process, allowing for more expeditious, secure, and accurate reporting of communicable disease cases. This has led to a number of benefits, including:

• Real-time data capture that allows for quicker identification of disease outbreaks.
• Minimization of errors associated with manual reporting.
• Less reporting burden on healthcare providers.
• Enhanced agency preparedness for public health crises.
• Improved coordination between health providers and public health agencies.

What Are the Laws on Using eCR?

Each state mandates a unique list of conditions that must be reported to the state’s public health agency. This is usually outlined on a state agency’s website. While healthcare professionals are legally required to report on these conditions, they don’t have to use an eCR to do so.

However, use of eCR is federally required for facilities that want to receive Promoting Interoperability funds from the Center for Medicare and Medicaid Services (CMS). This is a part of the Promoting Interoperability Program, which compensates participating facilities that meet standards of efficient EHR use.

Prior to implementing eCR, facilities will also need to work with their public health agencies and EHR vendors to ensure that their systems comply with HIPAA (Health Insurance Portability and Accountability Act), which protects the privacy of the patient information being transferred.

How Do Facilities Register for eCR?

The implementation of eCR is a joint effort between healthcare facilities, EHR vendors, and public health agencies. The exact registration process may look different depending on what state a facility is located in. To start the process, facilities will generally need to:

• Check whether their public health agency has confirmed readiness to receive eCR.
• Register for eCR through their local public health agency’s system.
• Contact the facility’s EHR vendor to confirm system compliance with eCR.

The CDC, Association of Public Health Laboratories, and the Council of State and Territorial Epidemiologists have also created a federal eCR system called eCR Now. For eligible states, facilities can work with their EHR vendors to sign up through the eCR website, which allows for rapid and seamless connection between an EHR and eCR system.

The eCR system will either be directly added onto a facility’s EHR or installed through an app that supports eCR functions. This typically comes with no additional cost if a facility’s EHR system already supports eCR capabilities.

Ready to Boost Compliance Efforts at Your Facility?

Now that you can answer the question, What is eCR used for? you may be wondering about other ways to maintain compliance within the rapidly changing healthcare industry. We’re here to help, with valuable healthcare resources and guides designed to boost your facility’s compliance efforts and minimize legal and financial risks.

Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current, as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.