All practitioners, health care facilities, and laboratories in Florida are required to notify the Florida Department of Health of diseases or conditions of public health significance under section 381.0031, Florida Statutes, and Chapter 64D-3, Florida Administrative Code.

Entities that provide both health care AND laboratory services (e.g., physicians providing point of care lab testing) must fulfill the requirement for health care providers AND laboratory providers.

SymbolMeaning
❗Report immediately 24/7 by phone upon
initial suspicion or laboratory test order.
❗*Report immediately during business
hours by phone upon initial suspicion
or laboratory test order.
☎Report immediately 24/7 by phone.
 ●Other reporting timeframe required.
 +Submit isolate or specimen for
confirmation.
Legend for Reportable Conditions

Reporting Requirements

Health Care Practitioners

Health Care Practitioners: Reportable Conditions
Health Care Practitioner Reporting Requirements

Facilities providing health care services must submit case reports for reportable diseases and conditions, in line with the reporting guidelines, to the appropriate county health department contact. Medical records must be made available for epidemiologic investigations.

Practitioners, who diagnose, test, or treat any reportable diseases, have two pathways for submitting case reports: 

How to fulfill requirement

Fax the Practitioner Disease Reporting Form and medical records pertaining to the patient’s infection to your county health department contact.

Reporting HIV/AIDS Cases

All cases of HIV or AIDS that meet the U.S. Centers for Disease Control and Prevention case definition must be reported on either the Adult HIV Confidential Case Report Form (CDC 50.42A, Rev. 1/2023) or the Pediatric HIV Confidential Case Report Form (CDC 50.42B, Rev. 1/2023).

All case report forms should be submitted to your local county health department within two weeks of diagnosis.

Electronic Laboratory Reporting (ELR)

Electronic laboratory reporting for public health is the transmission of digital laboratory reports, often from laboratories to state and local public health departments, health care systems, and CDC. ELR decreases time-consuming manual processes and increases efficiency of reporting requirements.

Practitioners, who are required to report point of care test results for selected diseases and conditions, have two pathways for participating in ELR:

Option 1

If your practice capable of generating a Health Level 7 (HL7) or comma separated value (CSV) file, you can use ELR. Submissions are made via secure file transfer protocol.

Option 2

If your practice is NOT capable of generating a HL7 CSV file, you can use the web portal that supports both individual manual data entry and batch data submissions.

Although electronic reporting is required, until an entity is fully onboarded as an ELR or web portal participant, it must continue to fax laboratory reports to the county health department or to the Florida Department of Health’s Bureau of Epidemiology at 850-414-6894.

ELR Resources

For questions about ELR, contact FloridaELR@FLHealth.gov. For questions about the web portal, contact ELRPortalSupport@FLHealth.gov.

Documentation for PI Attestation

Health care partners needing to attest to their engagement in public health reporting programs:

Electronic Case Reporting eCR

The Electronic case reporting (eCR) reporting/performance period for MIPS or PIP is a continuous, self-selected, 180-day period ending by December 31. eCR registrations must be received no later than 90 days before the end of the calendar year to be in active engagement for the current year; registrations received after October 3, are given active engagement status for the following year. 

eCR is required by the Centers for Medicare and Medicaid Services’ Promoting Interoperability Program for eligible hospitals and critical access hospitals and the Merit-Based Incentive Payment System Promoting Interoperability Performance Category for eligible clinicians.

By registering for eCR, you are not exempt from reporting cases to your local county health department. Please continue to manually report cases until you are fully onboarded with eCR and approved by DOH to discontinue manual reporting. 

Electronic Case Reporting eCR
Participate in eCR

The Florida Department of Health uses the HL7 CDA electronic initial case report (eICR) standards R3.1 or FHIR eCR 2.1 for electronic case reporting and to support the CMS Promoting Interoperability regulation and the HTI-1 Final Rule for eCR. It is these standards that we will use to eventually eliminate manual reporting requirements. For health care facilities and electronic health record products currently utilizing CDA R1.1, transition is required by August 2025. 

Benefits of eCR

  • Fulfills legal requirements: eCR allows providers to fulfill their legal obligations to report conditions of public health concern with less administrative burden.
  • Qualifies as a PIP objective: eCR qualifies as an objective for eligible facilities participating in the PIP, formerly called Meaningful Use.
  • Enhances surveillance: eCR enhances the efficiency and effectiveness of disease detection, surveillance, investigation, and response.
  • Increases automation: eCR increases automation, which allows stakeholders to spend more time providing care and preventing and controlling disease among the residents of Florida, especially those who are most vulnerable.

Participate in eCR

Step 1: Prepare

  • Verify your electronic health record (EHR) is on the certified health IT products list. Eligible hospitals and critical access hospitals attesting to the Medicare Promoting Interoperability Program will be required to only use certified health IT that has been updated consistent with the 2015 Edition Cures Update criteria to successfully meet the CEHRT requirements.
  • Visit the AIMS Platform website for a guide. If your vendor is not yet eCR ready, please still communicate intent with DOH. The vendor must be ready for the onboarding process to be completed.
  • The Florida Department of Health does not offer an exclusion letter for eCR related to the CMS PIP and the CMS MIPS programs. If you are an eligible hospital, CAH, or MIPS eligible clinician, if you have a hardship, or if you do not treat or diagnose any required reportable disease, during the EHR reporting and performance period, please check with a CMS representative if you would be excluded from the eCR measure. 

Step 2: Contact

Step 3: Implement

Step 4: Testing and Validation Phases

  • Enter a testing and validation status where your eCR data undergoes basic testing and validation by AIMS and further testing and validation by DOH

You must continue your existing reporting method for reportable conditions until you receive official notification from DOH authorizing you to discontinue manual reporting.

Step 5: Keep your system up to date with reporting requirements and software

  • Update your EHR software regularly. New trigger code sets are released twice annually under the Electronic Reporting and Surveillance Distribution (eRSD)
  • Ensure your EHR software has the most up to date eCR patches. Contact your EHR software support if you have questions.
  • Ensure your EHR product have the capability to submit Health Level 7 (HL7) electronic initial case report (eICR) standards R3.1 for electronic case reporting and to support the new HTI-1 Final Rule for eCR. R3.1 was a required transition by end of Q3 (August) 2025. 

Resources

Laboratories

Laboratories: Reportable Conditions
Laboratory Reporting Requirements

Facilities providing laboratory services must submit laboratory reports for reportable diseases and conditions, in line with the laboratory reporting guidelines.

How to fulfill requirement

Option 1: Electronic Laboratory Reporting

ELR supports electronic Health Level 7 (HL7) or Comma Separated Value (.CSV) files transferred via secure file transfer protocol.

Option 2: Fax reporting

Fax laboratory report directly to your county health department contact or to our central office fax number at 850-414-6894.

Electronic Laboratory Reporting (ELR)

Electronic laboratory reporting (ELR) for public health is the transmission of digital laboratory reports, often from laboratories to state and local public health departments, health care systems, and CDC. ELR decreases time-consuming manual processes and increases efficiency of reporting requirements.

Sign-Up and Access ELR

ELR supports electronic Health Level 7 (HL7) or comma separated value (.CSV) files transferred via secure file transfer protocol.

ELR Resources

For questions about ELR, contact FloridaELR@FLHealth.gov.

Documentation for PI Attestation

Health care partners needing to attest to their engagement in public health reporting programs:

National Electronic Case Reporting eCR System

The Electronic case reporting reporting/performance period for MIPS or PIP is a continuous, self-selected, 180-day period ending by December 31. eCR registrations must be received no later than 180 days before the end of the calendar year to be in active engagement for the current year; registrations received after October 3, are given active engagement status for the following year. 

eCR is required by the Centers for Medicare and Medicaid Services’ Promoting Interoperability Program for eligible hospitals and critical access hospitals and the Merit-Based Incentive Payment System Promoting Interoperability Performance Category for eligible clinicians.

By registering for eCR, you are not exempt from reporting cases to your local county health department. Please continue to manually report cases until you are fully onboarded with eCR and approved by DOH to discontinue manual reporting. 

Electronic Case Reporting eCR
Participate in eCR

The Florida Department of Health uses the Health Level 7 (HL7) electronic initial case report (eICR) and Reportability Response (RR) standards for eCR. It is these standards that we will use to eventually eliminate manual reporting requirements. Please ensure that your electronic health record (EHR) product is capable of supporting the HL7 implementation guides shown below:  

  • eICR R1.1 (HL7 CDA® R2 Implementation Guide: Public Health Case Report Release 2: the Electronic Initial Case Report (eICR) Release 1, STU Release 1.1 – US Realm)  
  • eICR R3.1.1 (HL7 CDA® R2 Implementation Guide: Public Health Case Report – the Electronic Initial Case Report (eICR) Release 2, STU Release 3.1.1 – US Realm)  
  • RR R1.1 (HL7 CDA® R2 Implementation Guide: Reportability Response, Release 1, STU Release 1.1 – US Realm)  
  • FHIR eCR R2.1.2 (HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR), Release 2.1.2 – US Realm)  

Important:  

  • All existing eICR R1.1 senders should update to eICR R3.1.1 by June 1, 2026 
  • Any new product implementations after January 1, 2026 must use eICR R3.1.1  

Benefits of eCR

  • Fulfills legal requirements: eCR allows providers to fulfill their legal obligations to report conditions of public health concern with less administrative burden.
  • Qualifies as a PIP objective: eCR qualifies as an objective for eligible facilities participating in the PIP, formerly called Meaningful Use.
  • Enhances surveillance: eCR enhances the efficiency and effectiveness of disease detection, surveillance, investigation, and response.
  • Increases automation: eCR increases automation, which allows stakeholders to spend more time providing care and preventing and controlling disease among the residents of Florida, especially those who are most vulnerable.

Participate in eCR

Step 1: Prepare

  • Verify your electronic health record is on the certified health IT products list. Eligible hospitals and critical access hospitals attesting to the Medicare Promoting Interoperability Program will be required to only use certified health IT that has been updated consistent with the 2015 Edition Cures Update criteria to successfully meet the CEHRT requirements.
  • Visit the AIMS Platform for a guide. If your vendor is not yet eCR ready, please still communicate intent with DOH. The vendor must be ready for the onboarding process to be completed.
  • The Florida Department of Health does not offer an exclusion letter for eCR related to the CMS PIP and the CMS MIPS programs. If you are an eligible hospital, CAH, or MIPS eligible clinician, if you have a hardship, or if you do not treat or diagnose any required reportable disease, during the EHR reporting and performance period, please check with a CMS representative if you would be excluded from the eCR measure. 

Step 2: Contact

Step 3: Implement

Step 4: Testing and Validation Phases

  • Enter a testing and validation status where your eCR data undergoes basic testing and validation by AIMS and further testing and validation by DOH

You must continue your existing reporting method for reportable conditions until you receive official notification from DOH authorizing you to discontinue manual reporting.

Step 5: Keep your system up to date with reporting requirements and software

  • Update your EHR software regularly. New trigger code sets are released twice annually under the Electronic Reporting and Surveillance Distribution
  • Ensure your EHR software has the most up to date eCR patches. Contact your EHR software support if you have questions.
  • Ensure your EHR product have the capability to submit Health Level 7 (HL7) electronic initial case report (eICR) standards R3.1 for electronic case reporting and to support the new HTI-1 Final Rule for eCR. R3.1 was a required transition by end of Q3 (August) 2025. 

Resources

If you have any questions, email us at ElectronicCaseReporting@FLHealth.gov.

Reporting Programs

One of the core functions of the Florida Department of Health is to assess and monitor population health status, factors that influence health, and community needs.

Electronic Case Reporting

Electronic Lab Reporting

Syndromic Surveillance

Florida SHOTS

Cancer Registry

E-FORCSE

Surveillance Systems

Merlin

The Merlin system is essential to the control of disease in Florida. It serves as the state’s repository of reportable disease case reports, including automated notification of staff about individual cases of high-priority diseases. Data collected in Merlin can be viewed using Florida’s Communicable Disease Frequency Reports.

Access to Merlin is available only to approved Department of Health employees. 

ESSENCE-FL

The Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE-FL) is a biosurveillance system utilized by public health professionals across Florida.

Data from 11 sources are stored within ESSENCE-FL: emergency departments, free-standing emergency departments, and urgent care visits; emergency medical service calls, poison control center calls, death records, reportable diseases (excluding cancer, HIV/AIDS, TB), inpatient hospitalizations, disaster medical assistance teams (when deployed in Florida), weather stations, and air quality.

ESSENCE-FL allows users to monitor overall trends by categorizing visits using patient chief complaints and discharge diagnoses. Integrated visualization tools enable overlaying of data from various data sources. Versatile free-text queries can be created by users, which allow data sources to be queried for any disease or hazard. ESSENCE-FL provides epidemiologists with the data sources and analytic tools needed to identify outbreaks or unusual trends more rapidly, leading to more timely public health responses.

The system is valued, trusted and relied upon daily by state and county level epidemiologists across FDOH program areas (epidemiology, immunizations, environmental health, vectorborne, waterborne and foodborne disease programs) to detect outbreaks and unusual cases, monitor morbidity and mortality, and provide situational awareness including after events such as hurricanes, wildfires, earthquakes, pandemic influenza, Gulf oil spill, etc.

The ESSENCE-FL system was designed by Johns Hopkins University Applied Physics Laboratory and the Walter Reed Army Institute for Research. For more information please view the ESSENCE user guide (FL. v2.0) or contact Essence.Help@FLHealth.gov.

The Florida Department of Health has an established online public health alert and notification network capable of rapid distribution of health alerts and messages to a defined set of individuals. The current application for the network that provides real-time secure communications is the Everbridge Mass Notification System.

Frequently Asked Questions

How do I get additional information about disease frequency in Florida?

Florida’s Communicable Disease Frequency Reports
Allows you to select the disease or condition of interest as well as other classifications to customize your reports.

Are disease outbreaks or clusters supposed to be reported?

Yes, any cluster or outbreak of disease is required to be reported. These clusters or outbreaks can be of any disease or condition, and is not limited only to those diseases included on the practitioner list of reportable diseases.

Contact your local county health department. If you are unable to reach your local county health department, if a public health emergency, or outside of regular business hours, please contact the Florida Department of Health’s Bureau of Epidemiology 24/7 at 850-245-4401.

Do you have information about MRSA in Florida?

Do you have information about MRSA in Florida?

The surveillance section provides information about methicillin-resistant Staphylococcus aureus and other antibiotic resistance information.

If patients get sick from food products, how should it be reported?

If you believe that you became ill from consuming contaminated food,  complete the online food and waterborne illness complaint form.

Food and Waterborne Illness Reporting
If illnesses originate from a cruise ship, how should it be reported?

If you believe that you became ill while on a cruise ship, contact your local county health department. 

If you are unable to reach your local county health department, if a public health emergency, or outside of regular business hours, please contact the Bureau of Epidemiology 24/7 at 850-245-4401.

Documentation for Promoting Interoperability Attestation

For the convenience of our health care partners needing to attest to their engagement in public health reporting programs, we have provided a list of facilities participating in syndromic surveillance (SyS), electronic laboratory reporting (ELR), and electronic case reporting (eCR).

Download PI List