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The Florida Department of Health works to protect, promote, and improve the health of all people in Florida through integrated state, county, and community efforts.

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Electronic Case Reporting (eCR)

Be a star!  Sign up for eCR.

Florida eCR participants are building a public health information superhighway.

A special thanks to the trailblazers below:

eCR Early Adopters

  • Memorial Health System
  • Leon Medical Centers
  • Premise Health
  • Lee Memorial Health System
  • Watson Clinic LLP
  • Johns Hopkins Medicine
  • Mayo Clinic

The Florida Department of Health declares they are ready to receive electronic case reports from eligible health care organizations.

 

Participate in eCR
Flordia ECR Information: As of April 2022, more than 11,400 facilities are actively sending COVID-19 via eCR to PHAs


Effective January 1, 2022, eCR is required by the Centers for Medicare and Medicaid Services' Promoting Interoperability Program (PIP) for eligible hospitals and critical access hospitals (CAHs) and the Merit-Based Incentive Payment System (MIPS) Promoting Interoperability Performance Category for eligible clinicians.

PLEASE NOTE: The upcoming deadline for eligible hospitals, critical access hospitals (CAHs), and clinicians to begin the reporting/performance period to meet the CY2025 requirement for CMS PIP and QPP MIPS for eCR is July 5th, 2025. It must be a continuous, self-selected, 180-day period ending by December 31, 2025.

Please read on to learn about eCR, its benefits, where to register your intent, and additional resources.

About eCR

Electronic case reporting (eCR) is the automated real-time exchange of case report information between electronic health records (EHRs) and public health agencies.

Traditionally, health care providers need to know the rules for reporting and manually report about cases, or people with conditions of public health concern, to their public health agencies via fax, phone call, or email.

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:

  • HL7 Clinical Document Architecture (CDA) implementation guides hl7.org/implement/standards/product_brief.cfm?product_id=436
    • 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)
  • HL7 Fast Healthcare Interoperability Resources (FHIR) Implementation Guide hl7.org/fhir/us/ecr/STU2.1
    • FHIR eCR R2.1.2 (HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR), Release 2.1.2 - US Realm)

 

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 Promoting Interoperability Program (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
  • Step 2: Contact
  • Step 3: Implement
  • Step 4: Testing and Validation Phases
  • Step 5: Keep your system up to date with reporting requirements and software.
  • Verify your electronic health record (EHR) is on the Certified Health IT Products List. Eligible hospitals and critical access hospitals (CAHs) 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. 
    *Note: If your vendor is not yet eCR ready, please still communicate intent below with FLDOH. However, know that 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, you are excluded from the eCR measure if you do not treat or diagnose any reportable disease for which data is collected per 64D-3, Florida Administrative Code, during the EHR reporting and performance period.

Communicate intent to participate in eCR with DOH:

Register your intent for eCR now

Work with your EHR vendor to connect to the APHL AIMS Platform

  • Enter a testing and validation status where your eCR data undergoes basic testing and validation by AIMS and further testing and validation by DOH
  • DOH has prepared this supplemental guidance document to be used as a companion to the Implementation Guide at time of onboarding for eCR. View eCR Supplental Guidance (This file provided in an Excel format upon request).
  • IMPORTANT: You must continue your existing reporting method for reportable conditions until you receive official notification from DOH authorizing you to discontinue manual reporting.
  • Update your EHR software regularly. New trigger code sets are released twice annually under the Electronic Reporting and Surveillance Distribution (eRSD) . Senders must conduct full triggering of eICRs (triggering for all conditions) by implementing eRSD version 3 or higher.

  • Any senders utilizing the eCR Now FHIR App must implement version 3.1.13 or higher (see latest version).

  • 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 has the capability to submit Health Level 7 (HL7) electronic initial case report (eICR) standards R3.1.1 for eCR. 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

Learn more about eCR

Questions

Should you have any questions, we are happy to support you. Please email us at ElectronicCaseReporting@FLHealth.gov