METHODS: To understand eICR content, we reviewed the HL7 CDA R2 Implementation Guide: Public Health Case Report, Release 2 documents in December 2015; analyses will be updated after balloting is complete. To describe disease-specific data elements requested by epidemiologists in CSTE PSs, we reviewed 63% (n=45) of 72 key PSs. We reviewed all PSs for bloodborne (n=4), enteric (n=13), sexually transmitted (n=4), and vaccine-preventable conditions (n=15), and some from each remaining categories. We abstracted disease-specific data elements listed in Section VI-C, and organized them by high-level categories and harmonized data elements where possible. We mapped elements represented in the eICR to those requested in PSs. Where possible, pre-coordinated concepts in the PS were mapped to concepts in data models used in eICR. For example, “date of rash onset” in the PS was mapped to “Date of onset” in the eICR, assuming each ‘problem’ or ‘observation’ could include a ‘start date’.
RESULTS: A total of 295 data elements were abstracted from the PSs. Most (89%) of the 90 data elements in the demographic, clinical and laboratory categories could be mapped to the eICR, assuming laboratory results are included in the eICR. Only 3 (5%) of the 63 data elements in the immunization, occupational, and sexual history categories could be mapped. Similarly, only 3 (2%) of the 138 data elements in the epidemiologic risk factors, and food or travel history categories could be loosely mapped to the eICR. Many concepts could be gathered during a clinical encounter, but some were very disease-specific and may be more appropriately gathered during a public health investigation after reporting has occurred.
CONCLUSIONS: The eICR under ballot includes demographic, clinical and laboratory information requested by epidemiologists to be in the initial case report. Other information available within the EHR is missing and should be evaluated for inclusion.