Electronic Case Reporting (eCR)

Texas eCR Onboarding Guidelines  eCR FAQs   eCR Resources

Electronic case reporting (eCR) is the generation and transmission of case reports from an electronic health record (EHR) to public health for review and action. eCR allows healthcare providers and facilities to automatically report cases of notifiable diseases to DSHS for further investigation from their EHR. eCRwill support earlier notifications to public health and provide more complete and accurate data. eCR is supported by the new Centers for Medicare & Medicaid Services (CMS) Promoting Interoperability Program (PIP) regulation. The initial stage of eCR focuses on the initial case report; later stages may include a response from public health to the reporting clinician that may include outbreak information for providers, links to treatment guidelines and recommendations, and other clinically relevant information.

DSHS has not yet declared readiness for eCR at this time in order to afford eligible hospitals valuable time to prepare their health systems to report eCR. Although DSHS has not yet declared readiness, DSHS is still accepting eCR messages submitted from hospitals who have completed onboarding with the Center for Disease Control & Prevention (CDC) and APHL Informatics Messaging Services (AIMS) platform. Texas strongly encourages all ready and eligible hospitals initiate the eCR process by following the steps listed below.

For latest updates on eCR from DSHS Texas, please check back here. Please note that when DSHS officially announces readiness for eCR ALL CAHs and EHs in Texas will be required to onboard at the state level with DSHS.

1. Confirm EHR system is eCR conformant CAHs and EHs must confirm having an EHR system that is able to produce a conformant message according to the HL7 Standards Product Brief - HL7 CDA® R2 Implementation Guide: Reportability Response, Release 1, STU Release 1.1 - US Realm | HL7 International.
2. Register with DSHS to submit eCR Please complete and submit the DSHS eCR registration form. After registering, DSHS will provide healthcare organization with instructions for beginning the process to onboard with DSHS. The items requested by DSHS can be worked on simultaneously while healthcare organizations also begin step 3 below.
3. Successfully onboard to production with APHL Informatics Messaging Services (AIMS)  EHs and CAHs may begin the eCR process by connecting and onboarding with AIMS at eCR@cdc.gov. This step will be completed when healthcare organization is able to successfully send production messages via AIMS. Please follow all guidance given by AIMS to complete this step.
4. Finalize eCR onboarding with DSHS DSHS will prioritize outreach to CAHs and EHs based upon facilities' onboarding completion date with AIMS in Step 3 above. DSHS’s onboarding activities will require registration (if not already completed), completed healthcare facility lists, and final validation assessing data quality and data completeness. When successfully completed, DSHS will approve healthcare organization for eCR production into Texas NEDSS where eCR data will be distributed to local and regional health departments for appropriate follow up.
5. eCR Parallel Production When an organization has successfully completed onboarding with both AIMS AND DSHS, they will remain in parallel production until explicitly told from DSHS to stop reporting manually. During this time local health departments will review data received manually (e.g., fax, phone, or mail) against data received via eICR messages to identify potential gaps. 
6. Release from Manual Reporting (TBD Criteria still under development) Important note: Unless DSHS explicitly directs your facility to stop submitting manual data, CAHs and EHs must continue to submit all case reports to their public health jurisdictions. DSHS is coordinating with local health departments to determine criteria for releasing facilities from manual reporting to public health.

When DSHS makes a declaration of readiness in the future, all CAHs and EHs in Texas will be required to register and onboard with DSHS. If your facility is located in the city of Houston, please also reference the Houston Electronic Case Reporting website for additional eCR requirements from HHD.

Questions on eCR onboarding in Texas should be submitted to TexasECR@dshs.texas.gov. For latest updates on eCR, please check back here on the DSHS eCR main webpage.