| Submitted By: Laura Conn | |
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| Data Element Information | |
| Use Case Description(s) | |
| Use Case Description | This data element in used in electronic case reporting (eCR) which provides case reports to state, tribal, local, or territorial (STLT) public health agencies (PHA) for up to 292 reportable diseases and conditions. Submission of reports of persons with these conditions is required by law in every US State and Territory. Public health epidemiologists have identified the data elements necessary to be included in electronic case reports from healthcare organizations and providers. The transition is underway from providing these reports via fax, mail, email, or phone to using data available in the electronic health records to submit reports electronically to all PHAs. As of September 13, 2020, over 9,300 healthcare facilities are using eCR to submit these data. Once received at the PHA, this data is use for surveillance, case management and public health response efforts such as contact tracing or other mitigation efforts. Specific to this data element: This is particularly important for people who travel across borders often and/or spend significant periods of time in another country. |
| Estimated number of stakeholders capturing, accessing using or exchanging | This data is exchanged as part of the extensive implementation of electronic case reporting in the US. Target is nationwide, currently 5400+ sites are reporting. There are between 56 and 2400 public health agencies using this data. Electronic case reporting is also cited in the Cares Act regulations. |
| Link to use case project page | https://www.cdc.gov/ecr/index.html |
| Healthcare Aims |
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| Maturity of Use and Technical Specifications for Data Element | |
| Applicable Standard(s) | HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) based on FHIR R4 HL7 CDA® R2 Implementation Guide: Public Health Case Report - the Electronic Initial Case Report (eICR) HL7 FHIR: Country of Residence profile HL7 CDA: Country of Residence template https://loinc.org/77983-5/ https://www.hl7.org/implement/standards/product_brief.cfm?product_id=519 https://www.hl7.org/implement/standards/product_brief.cfm?product_id=436 |
| Additional Specifications | 'HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) based on FHIR R4 HL7 CDA® R2 Implementation Guide: Public Health Case Report - the Electronic Initial Case Report (eICR) HL7 FHIR: Country of Residence profile HL7 CDA: Country of Residence template |
| Current Use | Extensively used in production environments |
| Supporting Artifacts |
Soon to be published: HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) STU Release 2 Soon to be published: HL7 CDA® R2 Implementation Guide: Public Health Case Report - the Electronic Initial Case Report (eICR) Release 1, STU Release 3.0 https://www.hl7.org/implement/standards/product_brief.cfm?product_id=519 https://www.hl7.org/implement/standards/product_brief.cfm?product_id=436 |
| Number of organizations/individuals with which this data element has been electronically exchanged | 5 or more. This data element has been tested at scale between multiple different production environments to support the majority of anticipated stakeholders. |
| Supporting Artifacts |
n/a |
| Potential Challenges | |
| Restrictions on Standardization (e.g. proprietary code) | None |
| Restrictions on Use (e.g. licensing, user fees) | None |
| Privacy and Security Concerns | None |
| Estimate of Overall Burden | These data elements are straightforward in nature and should not present a large burden to implement provided the EHR system is capturing the data. |
| Other Implementation Challenges | None |
| ONC Evaluation Details Each submitted Data Element has been evaluated based on the following 4 criteria. The overall Level classification is a composite of the maturity based on these individual criteria. This information can be used to identify areas that require additional work to raise the overall classification level and consideration for inclusion in future versions of USCDI |
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| Maturity – Standards/Technical Specifications | Comment Level - May be represented by a vocabulary standard or an element of a published technical specification. |
| Maturity - Current Use | Comment Level - Used in limited test environments or pilots |
| Maturity - Current Exchange | Comment Level - Demonstrates limited exchange with external organizations, on same or different EHR/HIT systems |
| Breadth of Applicability - # Stakeholders Impacted | Level 1 - Used by many, but not most, patients, providers or events requiring its use |
| Evaluation Comment | Assessed as a comment due to limited specific support documentation for use case (country of residence, not usual residence). |
Submitted by nedragarrett_CDC on 2022-04-28
CDC's comment on behalf of CSTE
Country of usual residence is important for understanding risk for many imported diseases such as tuberculosis, parasitic diseases, typhoid, previous dengue or malaria.