Electronic Case Reporting (eCR)

What is eCR?

Electronic Case Reporting (eCR) is the secure creation and transmission of case reports from an electronic health record (EHR) to public health agencies for disease tracking, case management, and contact tracing. Like traditional reporting, eCR captures critical patient and clinical data regarding demographics, comorbidities, immunizations, medications, and other treatments, but greatly reduces the burden of manual reporting.

Who can participate in eCR?

The Washington State Department of Health (DOH) began accepting registrations of intent for eCR in January 2018 and is currently accepting data via eCR from healthcare providers and facilities operating in Washington state as well as those providing care to state residents anywhere in the US. As of August 2021, we have onboarded over 400 facilities from 9 healthcare organizations and welcome more!

Why participate in eCR?

eCR enables healthcare providers to fulfill their mandated reporting requirements to DOH and report cases for further investigation from their EHR faster, more accurately, and more reliably than traditional, manual reporting.

eCR also allows eligible professionals, eligible hospitals, and critical access hospitals to satisfy the Center for Medicare and Medicaid Services (CMS) regulatory requirements of the Public Health and Clinical Data Exchange objective for the Promoting Interoperability (PI) Program and the Merit-based Incentive Payment System (MIPS).

How do I participate in eCR?

Step 1: Prepare

Verify that your EHR is

If you have any questions, please email us.

Step 2: Reach out

Communicate intent to participate in eCR by:

If you have any questions, please email us.

Step 3: Establish connection

Work with your EHR vendor to implement a connection to the APHL Integrated Messaging Service (AIMS) hub.

If you have any questions, please email the national eCR Support Team.

DOH is also interested in leveraging Washington's Health Information Exchange (HIE) OneHealthPort (OHP) to facilitate receiving eCR data. If you would like to connect to AIMS via OHP, please email us.

Step 4: Testing and Validation Phase

Once you have established connection, you will enter a ‘testing and validation' status during which your eCR data will undergo basic testing and validation by AIMS and further testing and validation by DOH.

If you have any questions, please email us.

Important Notes

  1. The DOH uses the HL7 eICR standards for eCR in support of notifiable condition reporting and the new CMS Promoting Interoperability Program regulations. The DOH requires the use of these standards because they play a vital role in our ability to eventually eliminate manual reporting requirements.
  2. Do not discontinue your existing reporting method for electronic case reported conditions (e.g., faxing reports to your local public health authority) until you receive official notification from DOH authorizing this action. This authorization will be issued after all testing and validation processes are completed. Washington State Department of Health will explicitly authorize stopping of manual case reporting on a disease-by-disease basis where applicable and after we have completed data quality validation. Please note, even after an organization completes data quality validation, the following conditions must still be reported manually in accordance with Washington Administrative Code WAC 246-101-110 and WAC 246-101-101: immediately notifiable conditions, conditions notifiable within 24 hours in cases where eICRs would not be received within 24 hours because of weekends or holidays, and notifiable conditions not supported by the Reportable Conditions Knowledge Management System (e.g., outbreaks or suspected outbreaks). Please email us at eCR@doh.wa.gov for an up-to-date list of notifiable conditions not supported by RCKMS when applicable.
  3. It is likely that not every notifiable condition will be activated for eCR when you onboard. Your organization will still be responsible for submitting those conditions manually.
  4. If you need attestation documentation to validate meeting CMS requirements, email us.

Frequently Asked Questions

Is reporting via eCR required?

Reporting via eCR is currently not mandated by Washington state law/rules, but will be required to receive PI funds from CMS.

What is the difference between electronic lab reporting and eCR?

Electronic lab reporting (ELR) is the electronic transmission from laboratories to public health of laboratory reports that identify notifiable conditions, while eCR is the automatic generation of an initial case report from a provider's EHR system and transmission to public health for review and action. Since providers interact directly with patients more than labs do, eCR has the potential for much richer data collection of socio-economic determinants of health, health history, and comorbidities; all of which support more effective public health. eCR is not intended to replace ELR or to serve as a substitute for any ELR requirements.

Does my EHR vendor need to be connected to Washington's HIE OneHealthPort (OHP) to participate in eCR?

No. However, in order to transmit eCR to AIMS and comply with HIPAA, either you or your EHR vendor must be an eHealth Exchange member, Carequality Implementer, or CommonWell Health Alliance member. If you are not represented in any of the above options, the APHL also offers a separate Electronic Case Reporting Participation Agreement (Word). Learn about the eCR Data Sharing Policy. DOH is also interested in leveraging OHP to facilitate receiving eCR data. If you would prefer to use OHP, please email us.

What if my EHR vendor is not yet ready to send and receive eICR right now in accordance with the HL7 CDA R2 Implementation Guide for eICR standard?

If your EHR vendor is not yet ready, you can begin the onboarding process by communicating intent, but the vendor must be ready for the onboarding process to be completed. Remember to continue to send all case reports for any notifiable conditions via fax.

Additional Resources

Web content last updated: 12/19/2022