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Electronic Case Reporting (eCR) is a reality at Houston Methodist and Houston Health Department

Posted By Kathryn Turner, Idaho Deputy Epidemiologist and CSTE Digital Bridge Liaison, Tuesday, December 18, 2018
Updated: Friday, December 21, 2018

Houston Methodist and Houston Health Department are the first hospital system and public health agency in the U.S. to launch electronic case reporting (eCR) using CSTE’s Reportable Conditions Knowledge Management System (RCKMS). The eCR approach was designed by key stakeholders in health care, public health, and health information technology under the Digital Bridge collaborative, an innovative partnership focused on improving data exchange between health care and public health.
Houston is the first of seven Digital Bridge pilot sites to implement eCR in production for reportable diseases. Houston Methodist utilized their electronic health record (EHR) system vendor, Epic who is also a Digital Bridge participant, with the Health Department’s Houston Electronic Disease Surveillance System, provided by their vendor, Maven. Other locations participating in the Digital Bridge eCR pilot are in California, Kansas, Massachusetts, Michigan, New York, and Utah.
CSTE has been building RCKMS with HLN Consulting and Northrop Grumman with funding from CDC since 2014. The tool provides comprehensive information on public health reporting requirements. RCKMS is comprised of three parts that ensure accurate, timely, and complete coverage of reportable conditions reporting criteria:
  • The authoring interface allows public health agencies to input, edit, and manage their jurisdiction-specific reporting criteria.
  • The knowledge repository stores these criteria for use in adjudicating eCR data sent by health care electronic health record systems containing clinical encounter information.
  • The decision support system uses the criteria in the knowledge repository to determine whether data sent in the eCR constitutes a reportable condition and which jurisdiction(s) the data should be sent. The decision support system also notifies the reporting organization about the reportability of the clinical encounter.
RCKMS is part of the larger technical solution for eCR, and the launch of this real-time, automated process promises to improve the timeliness, accuracy and completeness of data, allowing public health to quickly intervene and prevent the spread of disease. RCKMS has been deployed on the Association of Public Health Laboratories (APHL) Informatics Messaging Services (AIMS) platform, the combination resulting in an all-inclusive decision support intermediary for use by public health and reporters to improve data exchange.
The pilot implementation focuses on five conditions: chlamydia, gonorrhea, pertussis, salmonellosis, and Zika virus infection. Public health agencies currently receive provider case reports predominantly through time-intensive manual processes that involve paper (e.g., faxes), phone calls, or data entry into a web portal. These manual processes are time consuming, burdensome to reporters and public health, and inconsistent. To ensure accurate reporting, providers must know what, when, how, and to whom to report their clinical data. In addition, public health agencies must ensure all reporting mandate information is up to date and available to those required to report. RCKMS benefits both reporters and public health agencies by providing a centralized location for public health reporting requirements.
While Houston Methodist, Houston Health Department, and Epic may be the first partners to embark on bridging the gap in case report data exchange between health care and public health, public health agencies, health care partners, and EHR vendors across the country are excited about implementing eCR. Overall, I would encourage CSTE members to stay current on electronic case reporting activities, and especially RCKMS because it will soon be part of business as usual for public health.
The Reportable Condition Knowledge Management System (RCKMS) is an authoritative, real-time portal to enhance disease surveillance. RCKMS provides comprehensive information on public health reporting requirements to public health reporters, such as clinicians and laboratories. More information can be found on the CSTE Surveillance and Informatics Steering Committee page, Digital Bridge website, and CDC website.
HLN is a leading public health informatics consulting company focused on developing and supporting robust technical solutions addressing pressing public health needs. HLN is dedicated to the development, improvement, promulgation, and use of Open Source solutions in health information technology. For more information, visit https://www.hln.com.

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