Case Reporting to Public Health Agencies

Type	Standard / Implementation Specification	Standards Process Maturity	Implementation Maturity	Adoption Level	Federally required	Cost	Test Tool Availability
Implementation Specification	HL7 CDA R2 Implementation Guide: Reportability Response, Release 1, STU Release 1.1 - US Realm	Balloted Draft	Production		No	Free	Yes – Open
Implementation Specification	IHE-XDR (Cross-Enterprise Document Reliable Interchange)	Final	Production		No	Free	Yes
Implementation Specification	HL7 CDA® R2 Implementation Guide: Public Health Case Report – the Electronic Initial Case Report (eICR) Release 2, STU Release 1.1 – US Realm	Balloted Draft	Production		No	Free	Yes
Implementation Specification	Applicability Statement for Secure Health Transport Version 1.3	Final	Production		No	Free	Yes
Implementation Specification	HL7® CDA® R2 Implementation Guide: Public Health Case Report - the Electronic Initial Case Report (eICR) Release 2, STU Release 3.1 - US Realm	Balloted Draft	Production		No	Free	Yes
Implementation Specification	HL7 FHIR® Implementation Guide: Electronic Case Reporting (eCR) 2.1.1 - STU 2- US Realm	Balloted Draft	Pilot	Feedback Requested	No	Free	Yes

Limitations, Dependencies, and Preconditions for Consideration	Applicable Security Patterns for Consideration
Electronic Initial Case Report (eICR) and the Reportability Response are paired together in production implementations to build a complete workflow. Electronic case reporting involves reporting to State, Tribal, Local, and Territorial public health authorities. Electronic case reporting is implemented widely. Some additional implementation guides related to public health reporting follow. Reporting is often captured under a specialized registry with associated standards when not specified as a separate measure. These include: Early Hearing Detection and Intervention (EHDI) Office of Populations Affairs (OPA) Family Planning Reporting IHE Profile Note that the maturity level of FHIR resources may vary. The FHIR Maturity Model and each of the levels is described on the HL7 wiki. Direct is used as the transport for performing an unsolicited push for Case Reporting to Public Health Agencies in some jurisdictions. See An Unsolicited "Push" of Clinical Health Information to a Known Destination Between Systems. The Applicability Statement for Secure Health Transport Version 1.3 is a newer version of the standard that is available for health IT developers to voluntarily update and provide to their customers. It became available when it was added to the Approved Standards for 2022 through ONC’s Standards Version Advancement Process (SVAP).	Secure Communication – Create a secure channel for client-to-server and server-to-server communication. Secure Message Router – Securely route and enforce policy on inbound and outbound messages without interruption of delivery. Authentication Enforcer – Centralized authentication processes. Authorization Enforcer – Specifies access control policies. Credential Tokenizer – Encapsulate credentials as a security token for reuse (e.g., SAML, Kerberos). Assertion Builder – Define processing logic for identity, authorization and attribute statements. User Role – Identifies the role asserted by the individual initiating the transaction. Purpose of Use – Identifies the purpose for the transaction. FHIR Security Labels support compliance with laws, policies, and consent directives governing HIPAA PHI and specially protected information (SPI).

Limitations, Dependencies, and Preconditions for Consideration

Applicable Security Patterns for Consideration

Electronic Initial Case Report (eICR) and the Reportability Response are paired together in production implementations to build a complete workflow.
Electronic case reporting involves reporting to State, Tribal, Local, and Territorial public health authorities. Electronic case reporting is implemented widely.
Some additional implementation guides related to public health reporting follow. Reporting is often captured under a specialized registry with associated standards when not specified as a separate measure. These include:
- Early Hearing Detection and Intervention (EHDI)
- Office of Populations Affairs (OPA) Family Planning Reporting IHE
  Profile
Note that the maturity level of FHIR resources may vary. The FHIR Maturity Model and each of the levels is described on the HL7 wiki.
Direct is used as the transport for performing an unsolicited push for Case Reporting to Public Health Agencies in some jurisdictions. See An Unsolicited "Push" of Clinical Health Information to a Known Destination Between Systems.
The Applicability Statement for Secure Health Transport Version 1.3 is a newer version of the standard that is available for health IT developers to voluntarily update and provide to their customers. It became available when it was added to the Approved Standards for 2022 through ONC’s Standards Version Advancement Process (SVAP).

Secure Communication – Create a secure channel for client-to-server and server-to-server communication.
Secure Message Router – Securely route and enforce policy on inbound and outbound messages without interruption of delivery.
Authentication Enforcer – Centralized authentication processes.
Authorization Enforcer – Specifies access control policies.
Credential Tokenizer – Encapsulate credentials as a security token for reuse (e.g., SAML, Kerberos).
Assertion Builder – Define processing logic for identity, authorization and attribute statements.
User Role – Identifies the role asserted by the individual initiating the transaction.
Purpose of Use – Identifies the purpose for the transaction.
FHIR Security Labels support compliance with laws, policies, and consent directives governing HIPAA PHI and specially protected information (SPI).

Comment

Submitted by chris.baumgart… on 2022-09-20

WA State Department of Health eCR Comments

Washington State Department of Health appreciates having the standards listed on the “Case Reporting to Public Health Agencies” page and does not have any recommended changes at this time.

Submitted by chris.baumgart… on 2021-09-29

WA State Department of Health eCR Comments

Washington State Department of Health appreciates having the standards listed on the “Case Reporting to Public Health Agencies” page and does not have any recommended changes at this time.

Submitted by shellyspiro on 2018-10-01

Pharmacy HIT Collaborative's Comments on ONC's Proposed 2018 ISA

The Pharmacy HIT Collaborative supports the balloted drafts of HL7 CDA R2 Implementation Guide: Consolidated CDA Templates for Clinical Notes (US Realm), DSTU Release 2.1 (with errata); HL7 CDA Release 2 Implementation Guide: Reporting to Public Health Case Reporting, Release 1, DSTU Release 1.1 (US Realm), the Electronic Initial Case Report (eICR); HL7 FHIR Implementation Guide: Structured Data Capture (SDC) STU2; and HL7 CDA R2 Implementation Guide: Reportability Response Release 1, STU Release 1.0 (US Realm).