Electronic case reporting (eCR) is the automated, real-time exchange of case report information between electronic health records (EHRs) and public health agencies (PHAs). This information is crucial for tracking diseases, managing individual cases, and conducting contact tracing to prevent the spread of illnesses. With eCR, public health authorities can promptly provide feedback to health care providers regarding reportable conditions and potential outbreaks. This instantaneous exchange of information is especially vital during public health crises, as it helps in swift response and containment efforts.
Before the Covid-19 pandemic, fewer than 200 health care facilities in the United States could automatically send electronic health record (EHR) data to state and local public health agencies (PHAs). By mid-2022, that number rose to over 12,500, but many public health agencies are still scrambling today to implement eCR systems.
To assist these agencies in accessing and utilizing eCR data effectively, Altarum collaborates with the Association of Public Health Laboratories (APHL), providing expertise and implementation assistance. This partnership helps develop the necessary infrastructure and trains staff to facilitate the creation and utilization of eCR.
Healthcare providers are required to share reportable conditions with public health agencies. However, this process is often time-intensive, for some, manual, leading to data errors, reporting delays, and underreporting. The public health agencies require timely, complete data to effectively monitor diseases and outbreaks, yet they face challenges due to varying technical infrastructures, capacities, and capabilities.
To address these challenges, we conduct readiness assessments for PHAs using our proven Altarum Interoperability Methodology (AIM) which forms the foundation for jurisdiction Interoperability Roadmaps. Tailored for each PHA, these roadmaps include timelines, required resources, staff development plans, and a data management plan, providing them with direction on receiving, integrating, and consuming eCR payloads. Additionally, they address security, authentication, authorization, routing, and delivery. With these processes in place, PHAs are equipped to handle eCR mapping, filtering, and data management validation. We also provide toolkits and playbooks on eCR implementation for PHAs to reference.
“During the Covid-19 pandemic, our public health infrastructure was caught off guard,” said Chris Becker, Altarum’s Project Management Manager, Public Health Interoperability and IT Systems. With this APHL collaboration, “We’re benefiting all of public health by making sure the system works for everyone,” he said. “Electronic case reporting is one of the best ways to directly impact the modernization of our public health agencies.”
The demand for support on eCR is significant, underscored by the fact that PHAs in almost a quarter of the U.S. states have sought assistance from Altarum, many with multiple requests. This widespread outreach highlights the pressing need for guidance and expertise in implementing and optimizing eCR systems and the growing recognition of eCR’s importance in modern public health surveillance, underscoring the critical role that Altarum and APHL play in facilitating its successful adoption nationwide.
The efficiency, reliability, and completeness of the eCR process have the potential to improve population health in several ways, including saving time and resources for PHAs and reducing administrative burdens for health care providers. eCR benefits everyone involved in case reporting by providing timely, comprehensive data compared to manual reporting, thereby alleviating the workload for both healthcare facilities and public health staff.
“As soon as a reportable condition for a patient is entered into the provider’s EHR system, PHAs receive a validated electronic version of that data, enabling them to monitor disease outbreaks and public health emergencies efficiently. This has a significant impact on public health,” said Sujata Mallik, Altarum’s Public Health Interoperability and IT Systems Manager.
Altarum draws on our rich experience in public health information technology implementation and surveillance for this project. In 2004 we designed, and continue to operate, the MDHHS public health gateway and data quality tool. Additionally, we provided integration engine expertise for the Washington State Department of Health and established the Innovations in Newborn Screening Interoperability Resource Center for screening programs nationwide to advance interoperability and reduce morbidity and mortality.