BACKGROUND: Diseases can emerge and spread quickly, making the development of a health information infrastructure that permits rapid dissemination of information between health care providers and public health agencies critical. As more health care providers adopt health information technology (IT), the opportunity to leverage clinical information stored as structured data from electronic health records (EHRs) may yield significant benefits. Efforts around electronic immunization registry reporting, syndromic surveillance, and electronic laboratory reporting, have yielded improvements in the timeliness, completeness, and quality of reporting to public health. Reporting burdens on the health care community have been reduced through automation of previously manual processes. Electronic case reporting (eCR) should yield similar benefits. We will present the status of nationwide electronic case reporting (eCR) endeavors and discuss the path forward for public health departments at varying stages of readiness.
METHODS: In late 2016, an environmental scan and gaps analysis were conducted to determine the current status of eCR efforts. Based on that assessment and in collaboration with stakeholder organizations representing state and local health departments, common milestones and goals are being mapped into a nationwide eCR strategy to achieve widespread electronic case reporting.
RESULTS: There are many moving parts necessary for successful nationwide eCR implementation. The initial case report leverages data from many areas of the EHR, including clinical diagnoses, laboratory orders and results, patient demographics, patient contact information, patient history, and medications. Electronic case reporting encompasses more than 70 nationally notifiable conditions that are reportable to more than 3,000 public health jurisdictions. There are legal, technical, and resource challenges with eCR that may not have been present with other public health reporting activities. A common architecture is being implemented so that health care may connect with “one public health”. Current eCR collaborative efforts in the Digital Bridge Initiative showcase a novel partnership to address governance across all implicated stakeholders – public health, health care, and health IT. The nationwide eCR roadmap identifies next steps for each of these stakeholders based on their readiness status.
CONCLUSIONS: Current challenges in the eCR strategy include a lack of awareness of the status of the common architecture implementation, as well as a lack of understanding of what may be necessary to adopt eCR. The roadmap will begin to outline what each stakeholders’ path forward might look like and highlight the common goals that the nation should be working towards.